The effect of bariatric surgery on psychiatric course among patients with bipolar disorder.
The effect of bariatric surgery on psychiatric course among patients with bipolar disorder.
复制标题
减肥手术对双相情感障碍患者精神病程的影响。
DOI：
10.1111/bdi.12109
复制
发表时间：
2013
影响因子：
5.4
通讯作者：
McIntyre,RogerS
中科院分区：
文献类型：
--
作者：
Ahmed,AmeenaT;Warton,EMargaret;Schaefer,CatherineA;Shen,Ling;McIntyre,RogerS
减肥手术是治疗严重肥胖症最有效的方法。患有双相情感障碍的人增加了肥胖的风险，但有时由于他们的双相情感障碍诊断而被认为不适合进行减肥手术。本研究旨在确定减肥手术是否改变双相情感障碍稳定患者的精神病病程。MethodsA匹配队列研究（2006-2009年）平均随访2.17年内进行了凯泽永久北方加州，一组实践综合健康服务提供组织，提供医疗和精神病护理330万人。参与者是144名接受减肥手术的重度肥胖双相情感障碍患者，以及1，440名双相情感障碍对照患者，性别，医疗中心和同期健康计划成员匹配。对照组符合减肥手术的转诊标准。精神病住院治疗的风险比，以及从基线到第1年和第2年的门诊精神病利用率的变化，进行了groups.ResultsA组之间的比较，共有13名减肥手术患者（9.0%）和153名未暴露于手术（10.6%）在随访期间精神病住院治疗。在校正潜在混杂因素的多变量考克斯模型中，与减肥手术相关的精神病住院的风险比为1.03 [95%置信区间（CI）：0.83-1.23]。在完全饱和的多变量一般线性模型中，从基线到第1年，手术患者与对照组的门诊精神病利用率变化无显著差异（-0.4次访视/年，95% CI：-0.5至0.4）或基线至第2年（0.4次访视/年，95%CI：-0.1至1.0）.ConclusionsBariatric surgery did not affect psychiatric course among stable patients with bipolar disorder.这项研究的结果表明，双相情感障碍患者谁已被评估为稳定可以考虑减肥手术。
ObjectiveBariatric surgery is the most effective therapy for severe obesity. People with bipolar disorder have increased risk of obesity, yet are sometimes considered ineligible for bariatric surgery due to their bipolar disorder diagnosis. This study aimed to determine if bariatric surgery alters psychiatric course among stable patients with bipolar disorder.MethodsA matched cohort study (2006–2009) with mean follow‐up of 2.17 years was conducted within Kaiser Permanente Northern California, a group practice integrated health services delivery organization that provides medical and psychiatric care to 3.3 million people. Participants were 144 severely obese patients with bipolar disorder who underwent bariatric surgery, and 1,440 control patients with bipolar disorder, matched for gender, medical center, and contemporaneous health plan membership. Controls met referral criteria for bariatric surgery. Hazard ratio for psychiatric hospitalization, and change in rate of outpatient psychiatric utilization from baseline to Years 1 and 2, were compared between groups.ResultsA total of 13 bariatric surgery patients (9.0%) and 153 unexposed to surgery (10.6%) had psychiatric hospitalization during follow‐up. In multivariate Cox models adjusting for potential confounding factors, the hazard ratio of psychiatric hospitalization associated with bariatric surgery was 1.03 [95% confidence interval (CI): 0.83–1.23]. In fully saturated multivariate general linear models, change in outpatient psychiatric utilization was not significantly different for surgery patients versus controls, from baseline to Year 1 (−0.4 visits/year, 95% CI: −0.5 to 0.4) or baseline to Year 2 (0.4 visits/year, 95% CI: −0.1 to 1.0).ConclusionsBariatric surgery did not affect psychiatric course among stable patients with bipolar disorder. The results of this study suggest that patients with bipolar disorder who have been evaluated as stable can be considered for bariatric surgery.