Department of Psychological Sciences, Kent State University, Kent, Ohio.
Department of Primary Care, Sam Houston State University College of Osteopathic Medicine, Conroe, Texas.
Surg Obes Relat Dis. 2021 May;17(5):1008-1016. doi: 10.1016/j.soard.2021.01.012. Epub 2021 Jan 22.
Research identifying preoperative psychosocial predictors of bariatric surgery outcomes has yielded inconsistent results with minimal examination of longer-term outcomes. Utilizing a broadband measure of personality and psychopathology during the preoperative evaluation helps to identify preoperative risk factors for suboptimal bariatric surgery outcomes.
Examine predictors of outcome and the incremental contribution of presurgical psychological testing to various long-term bariatric surgery outcomes.
Academic medical center.
A total of 168 postoperative patients (average of 6 postoperative years) consented to participate in the outcome study. Participants were weighed by the trained research/clinical staff and completed a battery of self-report questionnaires, including measures assessing eating attitudes and behaviors and weight-related quality-of-life (QoL). Patients had completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) as part of the institution's routine preoperative psychosocial evaluation. Weight loss was calculated as percent total weight loss (%TWL) and percent weight regain (%WR) was calculated as a percentage of maximum weight loss. Other preoperative data were obtained from a review of each patient's electronic medical record (EMR). From the initial sample, 145 patients were retained for analyses in the present study.
Preoperative problematic eating variables predicted long-term postoperative problematic eating behaviors and body image concerns. Scores on preoperative MMPI-2-RF scales measuring Demoralization, Dysfunctional Negative Emotions, Antisocial Behaviors, and Hypomanic Activation were consistent incremental predictors of 6-year outcomes, accounting for an additional 3%-24% of the variability in postoperative eating behaviors and QoL.
The preoperative psychological evaluation can be used to identify predictors of long-term bariatric surgery outcomes. Identification of these risk factors provides important targets for pre- and postoperative clinical interventions to maximize surgical outcomes.
研究确定了肥胖手术结果的术前心理社会预测因素，但对长期结果的检查很少。在术前评估中利用人格和精神病理学的宽带测量有助于确定肥胖手术结果不理想的术前危险因素。
检查结果的预测因素以及术前心理测试对各种长期肥胖手术结果的增量贡献。
学术医疗中心。
共有 168 名术后患者（平均术后 6 年）同意参加结果研究。研究人员对参与者进行称重，并完成了一系列自我报告问卷，包括评估饮食态度和行为以及与体重相关的生活质量（QoL）的测量。患者已经完成了机构常规术前心理社会评估的明尼苏达多相人格问卷-2 重构形式（MMPI-2-RF）。体重减轻计算为总体重减轻百分比（%TWL），体重恢复百分比（%WR）计算为最大体重减轻的百分比。其他术前数据是从每位患者的电子病历（EMR）回顾中获得的。从初始样本中，保留了 145 名患者进行本研究的分析。
术前问题性饮食变量预测长期术后问题性饮食行为和身体形象问题。测量抑郁、功能失调性负性情绪、反社会行为和轻躁狂激活的术前 MMPI-2-RF 量表的分数是 6 年结果的一致增量预测因子，占术后饮食行为和 QoL 变异性的额外 3%-24%。
术前心理评估可用于识别长期肥胖手术结果的预测因素。识别这些风险因素为术前和术后临床干预提供了重要目标，以最大程度地提高手术结果。
