Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2013-0007
Trends in Psychiatry and Psychotherapy
Original Article

Psychological and health comorbidities before and after bariatric surgery: a longitudinal study

Comorbidades fisicas e psicologicas antes e depois da cirurgia bariatrica: um estudo longitudinal

Susana Sofia Pereira da Silva; Angela da Costa Maia

http://dx.doi.org/10.1590/2237-6089-2013-0007 Trends Psychiatry Psychother, vol.35, n4, p.264-271, 2013
PDF
SciELO
Downloads: 0
Views: 374

Abstract

INTRODUCTION: Morbid obesity has multiple implications for psychological and physical health. Bariatric surgery has been selected as the treatment of choice for this chronic disease, despite the controversial impact of the surgery on psychosocial health. The objective of this study was to describe candidates for bariatric surgery and analyze changes in weight, psychopathology, personality, and health problems and complaints at 6- and 12- month follow-up assessments. METHODS: Thirty obese patients (20 women and 10 men) with a mean age of 39.17±8.81 years were evaluated in different dimensions before surgery and 6 and 12 months after the procedure. RESULTS: Six and 12 months after bariatric surgery, patients reported significant weight loss and a significant reduction in the number of health problems and complaints. The rates of self-reported psychopathology were low before surgery, and there were no statistically significant changes over time. The conscientiousness, extraversion, and agreeableness dimensions increased, but neuroticism and openness remained unchanged. All changes had a medium effect size. CONCLUSIONS: Our results suggest that patients experience significant health improvements and some positive personality changes after bariatric surgery. Even though these findings underscore the role of bariatric surgery as a relevant treatment for morbid obesity, more in-depth longitudinal studies are needed to elucidate the evolution of patients after the procedure.

Keywords

Bariatric surgery, health problems, obesity, psychopathology

Resumo

INTRODUÇÃO: A obesidade mórbida tem várias implicações para a saúde psicológica e física. A cirurgia bariátrica tem sido o tratamento de escolha para essa doença crônica, apesar da controvérsia sobre o impacto da cirurgia na saúde psicossocial. O objetivo deste estudo foi descrever candidatos a cirurgia bariátrica e analisar mudanças no peso, psicopatologia personalidade, problemas e queixas de saúde desses pacientes em avaliações realizadas 6 e 12 meses após a cirurgia. MÉTODOS: Trinta pacientes obesos (20 mulheres e 10 homens) com idade média de 39,17±8,81 anos foram avaliados em diferentes dimensões antes da cirurgia e 6 e 12 meses após. RESULTADOS: Aos 6 e 12 meses após a cirurgia bariátrica, os pacientes relataram significativa perda de peso e significativa redução no número de problemas e queixas de saúde. As taxas de psicopatologia autorrelatada foram baixas antes da cirurgia e não sofreram mudanças significativas com o tempo. As dimensões conscienciosidade, extroversão e agradabilidade aumentaram, mas o neuroticismo e a abertura permaneceram inalteradas. Todas as mudanças apresentaram um tamanho de efeito médio. CONCLUSÕES: Os nossos resultados sugerem que os pacientes experimentam melhoras significativas em saúde e algumas mudanças positivas de personalidade após a cirurgia bariátrica. Embora esses achados reforcem o papel da cirurgia bariátrica como um tratamento relevante para a obesidade mórbida, mais estudos longitudinais e aprofundados são necessários para elucidar a evolução dos pacientes após a realização do procedimento.

Palavras-chave

Cirurgia bariatrica, problemas de saude, obesidade, psicopatologia

References

Special issue - Diet, nutrition and the prevention of chronic diseases: scientific background papers of the joint WHO/FAO Expert Consultation. .

Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. ;377:557-67.

Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N. Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Obes Surg. ;17:260-70.

McEwen LN, Coelho RB, Baumann LM, Bilik D, Nota-Kirby B, Herman WH. The cost, quality of life impact, and cost-utility of bariatric surgery in a managed care population. Obes Surg. ;20:919-28.

Chantler PD, Lakatta EG. Role of body size on cardiovascular function: can we see the meat through the fat?. Hypertension. ;54:459-61.

Torgerson JS, Sjöström L. The Swedish obese subjects (SOS) study - rationale and results. Int J Obes Relat Metab Disord. ;25(^s1):S2-S4.

Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. ;357:741-52.

Sullivan M, Karlsson J, Sjöström L, Backman L, Bengtsson C, Bouchard C. Swedish obese subjects (SOS) - an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord. ;17:503-12.

Abilés V, Rodríguez-Ruiz S, Abilés J, Mellado C, García A, Pérez de la Cruz A. Psychological characteristics of morbidly obese candidates for bariatric surgery. Obes Surg. ;20:161-67.

Black DW, Goldstein RB, Mason EE. Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients. Am J Psychiatry. ;149:227-34.

Kalarchian MA, Marcus MD, Levine MD, Soulakova JN, Courcoulas AP, Wisinski MS. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis. ;4:544-49.

Wadden TA, Stunkard AJ. Handbook of obesity treatment. .

Mitchell JE, Zwaan M. Bariatric surgery. .

Guisado JA, Vaz FJ. Personality profiles of the morbidly obese after vertical banded gastroplasty. Obes Surg. ;13:394-98.

Castelnuovo-Tedesco P. Psychological consequences of physical defects: a psychoanalytic perspective. Int Rev Psychoanal. ;8:145-54.

Castelnuovo-Tedesco P. Bypass surgery for superobesity. The psychological experience of surgery. .

Bruch H. Eating disorders. .

Hutzler JC, Keen J, Molinari V, Carey L. Super-obesity: a psychiatric profile of patients electing gastric stapling for the treatment of morbid obesity. J Clin Psychiatry. ;42:458-62.

Petry NM, Barry D, Pietrzak RH, Wagner JA. Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med. ;70:288-97.

Silva SS, Maia AC. Adverse childhood experiences, psychological characteristics and physical health problems: comparison among obese and non-obese. Rev Psiquiatr Clin. ;38:194-200.

Larsen F. Psychosocial function before and after gastric banding surgery for morbid obesity. A prospective psychiatric study. Acta Psychiatr Scand Suppl. ;359:1-57.

de Haes JC, van Knippenberg FC, Neijt JP. Measuring psychological and physical distress in cancer patients: structure and application of the Rotterdam Symptom Checklist. Br J Cancer. ;62:1034-038.

Canavarro C. Brief Symptom Inventory.Testes e provas psicológicas em Portugal. .

Derogatis LR, Unger R. Symptom Checklist-90-Revised. The Corsini encyclopedia of psychology. .

Costa PT, McCrae RR. Age changes in personality and their origins: comment on Roberts, Walton, and Viechtbauer (2006). Psychol Bull. ;132:26-8.

Green S, Salkind N. Using SPSS for Window and Macintosh. .

Byrne S, Cooper Z, Fairburn C. Weight maintenance and relapse in obesity: a qualitative study. Int J Obes Relat Metab Disord. ;27:955-62.

Nelbom B, Naver L, Ladelund S, Hornnes N. Patient characteristics associated with a successful weight loss after bariatric surgery. Bariatr Nurs Surg Patient Care. ;5:313-19.

Belanger SB, Wechsler FS, Nademin ME, Virden TB. Predicting outcome of gastric bypass surgery utilizing personality scale elevations, psychosocial factors, and diagnostic group membership. Obes Surg. ;20:1361-371.

Ray EC, Nickels MW, Sayeed S, Sax HC. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. ;134:555-63.

Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. ;164:328-34.

Roberts BW, Walton K, Bogg T, Caspi A. De-investment in work and non-normative personality trait change in young adulthood. Eur J Pers. ;20:461-74.

Roberts B, Mroezek D. Personality trait change in adulthood. Curr Dir Psychol Sci. ;17:31-5.

Calugi S, Dalle Grave R, Marchesini G. Night eating syndrome in class II-III obesity: metabolic and psychopathological features. Int J Obes (Lond). ;33:899-904.

616b267aa95395351f048ee3 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections