Caracterização psicológica dos pacientes com obesidade severa, antes e depois da cirurgia bariatárica
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2014
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Apesar de a prevalência de psicopatologia entre candidatos de cirurgia bariátrica ser superior à da população não obesa, sabe-se pouco sobre o impacto da cirurgia em termos psicopatológicos. O principal objectivo deste estudo foi caracterizar a evolução de morbilidade psicopatológica em doentes submetidos a cirurgia bariátrica. Estudo observacional longitudinal. Foram incluídos todos os doentes submetidos a cirurgia bariátrica entre Março 2008 e
Junho 2010 num hospital geral da região sul de Portugal. A avaliação psicológica foi feita através de entrevista clínica estruturada, com aplicação do MCMI-III (mesmo protocolo antes e 12 meses após a cirurgia). Participaram 20 doentes (19 mulheres). Os síndromes de eixo 1 do DSM-IV mais prevalentes antes da cirurgia foram: ansiedade (40%), distimia (20%), perturbação somatoforme e perturbação delirante (15% cada). Depois da cirurgia, os mais prevalentes foram: ansiedade (40%), perturbação bipolar, distimia, e perturbação delirante (15% cada). A perturbação da personalidade mais prevalente (pré-cirurgia) foi a compulsiva (15%). Depois da cirurgia, foram: histriónica, compulsiva, e paranóide (10% cada). Em conclusão, a cirurgia bariátrica parece não ser eficaz, por si só, para a remissão de psicopatologia associada à obesidade severa.
Although psychological disorders are more prevalent among candidates for bariatric surgery than among non-obese populations, there is limited knowledge about the impact of this type of surgery on psychopathology. The main goal of this study was to characterize the evolution of psychopathological morbidity among obese patients after surgery. This was an observational longitudinal study. All patients submitted to bariatric surgery between March 2008 and June 2010, in a general hospital located in the south of Portugal were invited to participate. Psychological assessment was done through structured clinical interviews and administration of MCMI-III. Participants were assessed with the same protocol before and after surgery (minimum, 12 months after surgery). Overall, 20 patients (19 women) were assessed. The most prevalent clinical syndromes (axis I) before surgery were: anxiety (40%), dysthymia disorder (20%), somatoform disorder and delusional disorder (both 15%). After surgery, the most prevalent clinical syndromes were: anxiety (40%), bipolar disorder, dysthymia disorder, and delusional disorder (all with 15%). Before surgery, compulsive personality was the most prevalent personality disorder (15%). After surgery, the most prevalent ones were: histrionic personality, compulsive personality disorder, and paranoia (all with 10%). These findings may suggest that bariatric surgery per se is not enough as treatment for the remission of psychopathology among severe obese patients.
Although psychological disorders are more prevalent among candidates for bariatric surgery than among non-obese populations, there is limited knowledge about the impact of this type of surgery on psychopathology. The main goal of this study was to characterize the evolution of psychopathological morbidity among obese patients after surgery. This was an observational longitudinal study. All patients submitted to bariatric surgery between March 2008 and June 2010, in a general hospital located in the south of Portugal were invited to participate. Psychological assessment was done through structured clinical interviews and administration of MCMI-III. Participants were assessed with the same protocol before and after surgery (minimum, 12 months after surgery). Overall, 20 patients (19 women) were assessed. The most prevalent clinical syndromes (axis I) before surgery were: anxiety (40%), dysthymia disorder (20%), somatoform disorder and delusional disorder (both 15%). After surgery, the most prevalent clinical syndromes were: anxiety (40%), bipolar disorder, dysthymia disorder, and delusional disorder (all with 15%). Before surgery, compulsive personality was the most prevalent personality disorder (15%). After surgery, the most prevalent ones were: histrionic personality, compulsive personality disorder, and paranoia (all with 10%). These findings may suggest that bariatric surgery per se is not enough as treatment for the remission of psychopathology among severe obese patients.
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MEDICINA, OBESIDADE, CIRURGIA BARIÁTRICA, AVALIAÇÃO PSICOLÓGICA, MEDICINE, OBESITY, PSYCHOLOGICAL EVALUATION, BARIATRIC SURGERY