Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
Department of Mental Health, Azienda Sanitaria Giuliano-Isontina-ASUGI, Trieste, Italy.
Eat Weight Disord. 2022 Oct;27(7):2845-2855. doi: 10.1007/s40519-022-01424-4. Epub 2022 Jul 13.
This longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (%EBMIL) over shorter to longer periods.
Adult candidates for BS (N = 334, 67.4% females) completed the Symptoms Checklist 90 (SCL-90) questionnaire; on average, 11 months occurred between the pre-surgery psychological evaluations and the bariatric intervention. We explored the factor structure of the SCL-90 items and inspected how SCL-90 empirical factors compared with SCL-90 scales and general indices predicted %EBMIL at 3-6-month, 1-year, and 2-year follow-up occasions, adjusting for gender, pre-intervention use of antidepressants and actual and ideal BMIs.
Factor analysis combined the 90 items into 8 factors, which partially replicated the expected item structure. The SCL-90 empirical factors (but not the SCL-90 scales and indices) contributed to predict BS success. In fact, the Relational Distress factor directly protected from weight regain at 1-year follow-up, indirectly via 1-year %EBMIL at the 2-year follow-up, when it further strengthened the impact of the empirical factor of Generalized Anxiety on the 2-year BS outcome. The results also evidenced a cascade effect of the pre-surgery actual BMI across time as well as unique and direct effects of pre-surgery use of antidepressants and perceived ideal BMI on the 2-year outcome.
SCL-90 empirical factor scores for obese patients are more efficient in anticipating BS success compared with original scale scores. They reveal that relational distress and anxiety are risk factors for postoperative weight loss, in addition to pre-intervention actual BMI, antidepressant therapy, and perceived ideal BMI.
III, well-designed cohort.
本纵向研究探讨了术前心理健康状况如何预测减重手术 (BS) 成功的程度，即预计体重指数降低百分比（%EBMIL）在较短至较长时间内的情况。
接受 BS 的成年患者（N=334，女性占 67.4%）完成了症状清单 90 项（SCL-90）问卷；术前心理评估与减重干预之间平均间隔 11 个月。我们探讨了 SCL-90 项目的因子结构，并检查了 SCL-90 实证因子与 SCL-90 量表和一般指标如何预测 3-6 个月、1 年和 2 年随访时的 %EBMIL，同时调整了性别、术前使用抗抑郁药以及实际和理想 BMI 的影响。
因子分析将 90 个项目合并为 8 个因子，部分复制了预期的项目结构。SCL-90 实证因子（而非 SCL-90 量表和指标）有助于预测 BS 成功。事实上，关系困扰因子直接保护了 1 年随访时的体重反弹，间接通过 2 年随访时的 1 年 %EBMIL，同时进一步增强了实证因子对 2 年 BS 结果的影响。研究结果还表明，术前实际 BMI 具有时间上的级联效应，以及术前使用抗抑郁药和感知理想 BMI 对 2 年结果的独特和直接影响。
与原始量表得分相比，肥胖患者的 SCL-90 实证因子得分更能预测 BS 成功。它们表明，关系困扰和焦虑是术后体重减轻的风险因素，除了术前实际 BMI、抗抑郁治疗和感知理想 BMI 之外。
III 级，精心设计的队列研究。
