Every-Palmer Susanna, Romans Sarah E, Stubbs Richard, Tomlinson Anneka, Gandhi Sophie, Huthwaite Mark
Department of Psychological Medicine, University of Otago, Wellington, New Zealand.
Wakefield Obesity Surgery, Wakefield Hospital, Wellington, New Zealand.
Front Psychiatry. 2020 May 12;11:419. doi: 10.3389/fpsyt.2020.00419. eCollection 2020.
Bariatric surgery is seldom accessed by people with serious mental illness, despite high rates of obesity in this population. It is sometimes assumed that patients with complex psychiatric histories will have poor post-surgical weight loss or exacerbation of psychiatric symptoms, although this is unsubstantiated.
A qualitative descriptive study to explore personal experiences and the impact of bariatric surgery on physical and mental well-being and life-quality in individuals with serious mental illness.
Nine adults with a history of bariatric surgery and concurrent severe depressive disorder, bipolar disorder, or schizoaffective disorder were interviewed about their experiences of bariatric surgery and its outcomes using semi-structured interview schedules. Data were transcribed and inductive thematic analysis undertaken.
Five broad themes emerged: (1) surgery was highly effective for weight loss, and resulted in subjective improvements in physical health, quality of life, and mental health described as ; (2) recovering from surgery was a , notably in the post-operative period where negative sequelae often anteceded benefits; (3) post-operative support was important, but sometimes insufficient, including from families, mental health services, and surgical teams; (4) most considered surgery life-changing, recommending it to others with mental illness and obesity, two had different experiences; (5) participants considered it discriminatory that people with mental illness were not referred or declined weight loss surgery.
Participants benefited from bariatric surgery and felt it should be offered to others with mental illness, but with additional care and support.
尽管严重精神疾病患者的肥胖率很高，但他们很少接受减肥手术。有时人们认为，有复杂精神病史的患者术后体重减轻情况不佳或精神症状会加重，尽管这一点并无事实依据。
进行一项定性描述性研究，以探索减肥手术对严重精神疾病患者的个人经历、身心健康及生活质量的影响。
采用半结构化访谈提纲，对9名有减肥手术史且同时患有重度抑郁症、双相情感障碍或分裂情感障碍的成年人进行访谈，了解他们的减肥手术经历及其结果。对数据进行转录并开展归纳主题分析。
出现了五个广泛的主题：（1）手术对减肥非常有效，并在身体健康、生活质量和心理健康方面带来了主观改善，被描述为 ；（2）从手术中恢复是一个 ，尤其是在术后阶段，负面后遗症往往先于益处出现；（3）术后支持很重要，但有时不足，包括来自家庭、心理健康服务机构和手术团队的支持；（4）大多数人认为手术改变了生活，向其他患有精神疾病和肥胖症的人推荐了手术，有两人有不同的经历；（5）参与者认为精神疾病患者未被转诊或被拒绝进行减肥手术是一种歧视。
参与者从减肥手术中受益，并认为应向其他患有精神疾病的人提供这种手术，但需要额外的护理和支持。
