Department of Clinical and Experimental Medicine, University of Pisa, Italy.
Department of Anesthesia and Intensive Care, University of Pisa, Italy.
Riv Psichiatr. 2023 Mar-Apr;58(2):76-83. doi: 10.1708/4022.39977.
Candidates for bariatric surgery are routinely screened for psychiatric disorders because abnormal eating behaviors are considered common among these patients. This study aimed to evaluate the frequency and persistence, in terms of one month-to-lifetime prevalence ratio, of binge eating disorder (BED) and the potential association with impulsivity features and bipolar spectrum comorbidity in a sample of obese patients undergoing a psychiatric evaluation for bariatric intervention.
Overall, 80 candidates to bariatric surgery were assessed consecutively over 12 months within the framework of a collaboration between the University of Pisa Psychiatry and Internal Medicine Departments. Patients were evaluated through structured clinical interviews and self-report questionnaires.
The lifetime and last-month frequencies of BED according to DSM-5 criteria were 46.3% and 17.5%, respectively, with a prevalence ratio of 37.8%. Rates of formal bipolar disorder diagnoses were extremely low in patients with or without BED. However, patients with BED showed more severe dyscontrol, attentional impulsivity and bipolar spectrum features than patients with no BED.
The relationship of BED, impulsivity, and mood disorders in bariatric patients is more complex than usually reported in the literature. In particular, the presence of bipolar spectrum features should be systematically investigated in these patients because of their essential clinical and therapeutical implications.
由于异常的进食行为在这些患者中较为常见，因此对接受减重手术的患者进行精神障碍的常规筛查。本研究旨在评估在接受减重手术的肥胖患者中，暴食障碍（BED）的发生率和持续性（以 1 个月至终身患病率比表示），以及其与冲动特征和双相谱系共病的潜在关联。
总体而言，80 名候选者在 Pisa 大学精神病学和内科系合作框架内连续 12 个月接受评估。通过结构化临床访谈和自我报告问卷对患者进行评估。
根据 DSM-5 标准，BED 的终身和上月发生率分别为 46.3%和 17.5%，患病率比为 37.8%。有或没有 BED 的患者中，正式的双相情感障碍诊断率极低。然而，与没有 BED 的患者相比，有 BED 的患者表现出更严重的失控、注意力冲动和双相谱系特征。
在接受减重手术的患者中，BED、冲动和心境障碍之间的关系比文献中通常报道的更为复杂。特别是，由于其重要的临床和治疗意义，应系统地调查这些患者中双相谱系特征的存在。
