New-Onset Substance Use Disorder After Gastric Bypass Surgery: Rates and Associated Characteristics
New-Onset Substance Use Disorder After Gastric Bypass Surgery: Rates and Associated Characteristics
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DOI：
10.1007/s11695-014-1317-8
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发表时间：
2014-11-01
期刊：
影响因子：
2.9
通讯作者：
Schuh, Leslie M.
中科院分区：
文献类型：
--
作者：
Ivezaj, Valentina;Saules, Karen K.;Schuh, Leslie M.
物质使用障碍（SUD）可能会在减肥手术患者的一个亚组中重新发生，特别是那些接受过Roux-en-Y胃旁路术（RYGB）的患者。本研究在广泛的RYGB患者样本中检查SUD的发生率，并确定相关的行为和心理因素。参与者包括143名RYGB患者;大多数是女性（n = 120; 83.9%）和白色（n = 135; 94.4%）。参与者完成了一项基于网络的调查，评估了术前物质使用、饮食病理学、家族史和创伤史、术后物质使用、生活压力源和整体特质样测量的回顾性描述（情绪失调、冲动、寻求刺激和应对技能）。（n = 28，19.6%）的RYGB后患者符合可能SUD的标准;然而，大多数符合术后SUD标准的患者（n = 19，68%）未报告RYGB前SUD病史。药物滥用家族史、应对能力差和潜在的生活压力源与RYGB后SUD相关，尤其是新发组。此外，大多数符合RYGB前SUD标准的患者（n = 21，70%）在RYGB后不继续符合SUD标准。研究结果强调了RYGB后报告新发SUD的患者亚组，这在中年女性中是出乎意料的。重要的是，研究结果还表明，许多术前SUD患者术后未复发。建议在术前评估时评估SUD家族史和应对技能。未来的研究应确定SUD术后的心理和生理危险因素，并检查那些术后停止使用药物的保护因素。
Substance use disorder (SUD) may develop de novo for a subgroup of weight loss surgery patients, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The present study examined the rate of SUD in a broad sample of RYGB patients and identified associated behavioral and psychological factors.Participants included 143 RYGB patients; the majority were women (n = 120; 83.9 %) and white (n = 135; 94.4 %). Participants completed a web-based survey assessing retrospective accounts of presurgical substance use, eating pathology, family history, and traumatic history, postsurgical substance use, life stressors, and global trait-like measures (emotion dysregulation, impulsivity, sensation-seeking, and coping skills).A subgroup (n = 28, 19.6 %) of post-RYGB patients met criteria for probable SUD; however, the majority of those who met SUD criteria postsurgery (n = 19, 68 %) did not report a pre-RYGB SUD history. Family history of substance abuse, poor coping skills, and potential life stressors were related to post-RYGB SUD, particularly for the new-onset group. Additionally, the majority of those who met criteria for pre-RYGB SUD (n = 21, 70 %) did not continue to meet SUD criteria following RYGB.Findings highlight a subgroup of post-RYGB patients reporting new-onset SUD, which is unexpected among middle-aged women. Importantly, findings also indicate that many patients with presurgical SUD did not relapse postsurgery. Assessing for family history of SUD and coping skills at the presurgical evaluation is recommended. Future research should identify psychological and physiological risk factors for SUD postsurgery and examine protective factors of those who discontinue substance use postsurgery.