Axis I Psychopathology in Bariatric Surgery Candidates with and without Binge Eating Disorder: Results of Structured Clinical Interviews
Axis I Psychopathology in Bariatric Surgery Candidates with and without Binge Eating Disorder: Results of Structured Clinical Interviews
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DOI：
10.1007/s11695-010-0322-9
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发表时间：
2012-03-01
期刊：
影响因子：
2.9
通讯作者：
Williams, Noel N.
中科院分区：
文献类型：
--
作者：
Jones-Corneille, LaShanda R.;Wadden, Thomas A.;Williams, Noel N.
先前的研究得出了相互矛盾的结论，即暴饮暴食障碍(Bed)是否与寻求减肥手术的极端肥胖患者的更大精神病理有关。这项研究使用结构化DSM-IV诊断临床访谈(SCID)来比较被确定有床或目前没有进食障碍的外科候选人的Axis I精神病理学的比率。研究还检查了床与其他心理社会功能和减肥目标的关系。195名减肥手术患者完成了体重和生活方式问卷以及贝克抑郁问卷-II(BDI-II)，随后接受了饮食紊乱检查。在这些人中，44人被诊断患有睡眠呼吸暂停综合症，61人目前没有饮食病理，他们完成了电话控制的SCID。显著多于没有卧床的参与者目前有情绪障碍(27.3%比4.9%，p=0.002)以及这种疾病的终生病史(52.3%比23.0%，p=0.003)。与不睡觉的参与者相比，更多的卧床者还患有当前焦虑症(27.3%对8.2%，p=0.014)和终生焦虑症(36.4%对16.4%，p=0.019)。根据BDI-II的测量，BED还与更严重的抑郁症状以及更低的自尊有关。然而，卧床组和不卧床组在手术后的理想减肥目标上并没有区别。目前的研究结果表明，在寻求减肥手术的患者中，卧床与轴心I精神病理的患病率增加有关，而不是严重(即III级)肥胖者已经观察到的高发病率。
Prior studies have reached contradictory conclusions concerning whether binge eating disorder (BED) is associated with greater psychopathology in extremely obese patients who seek bariatric surgery. This study used the Structured Clinical Interview for DSM-IV Diagnoses (SCID) to compare rates of axis I psychopathology in surgery candidates who were determined to have BED or to be currently free of eating disorders. The relationship of BED to other psychosocial functioning and weight loss goals also was examined.One hundred ninety five bariatric surgery patients completed the Weight and Lifestyle Inventory and the Beck Depression Inventory-II (BDI-II) and were later administered the Eating Disorder Examination. Of these 195, 44 who were diagnosed with BED, and 61 who were currently free of eating pathology, completed a telephone-administered SCID.Significantly more BED than non-BED participants had a current mood disorder (27.3% vs. 4.9%, p = 0.002) as well as a lifetime history of this condition (52.3% vs. 23.0%, p = 0.003). More BED than non-BED participants also had a current anxiety disorder (27.3% vs. 8.2%, p = 0.014) and lifetime anxiety disorder (36.4% vs. 16.4%, p = 0.019). BED also was associated with greater symptoms of depression, as measured by the BDI-II, as well as with lower self-esteem. BED and non-BED groups, however, did not differ in their desired weight loss goals following surgery.The present findings indicate that the presence of BED, in patients who seek bariatric surgery, is associated with an increased prevalence of axis I psychopathology, beyond the already elevated rate observed with severe (i.e., class III) obesity.