Bariatric Surgery Candidate, Psychological Distress, Severe Obesity
Conditions
Keywords
Severe obesity, Resilience, Trauma, Psychological disorders, Eating disorders, Bariatric surgery
Brief summary
A high prevalence of psychological trauma on one hand and of psychiatric disorders, such as depression, anxiety, suicide attempts, addictions, and eating disorders on the other hand, has been reported in patients with severe obesity seeking bariatric surgery. Some studies reported an increased prevalence of these psychiatric disorders after bariatric surgery, potentially related to weight regain. In this context, psychological resilience is a concept that brings together internal and external factors of adaptation, and whose clinical use facilitates interdisciplinary collaborative work. This research focuses on the association between resilience and success or failure of bariatric surgery in patients followed in the Specialized Obesity Center (CSO) of the Nancy University Hospital. The hypothesis is that psychological resilience before surgery promotes successful surgical treatment. This retrospective study is based on existing data from patients with severe obesity who have undergone bariatric surgery at the Nancy CSO. The main objective is to study 1) the resilience of patients with severe obesity, candidates for bariatric surgery, at the first assessment (T0), at the end of lifestyle/behavioral modifications program (T1) and at 2 years after bariatric surgery (T2), 2) the relationship between internal and external factors explaining resilience and final weight outcomes. The investigators are expected that non-resilient patients have more psychological vulnerabilities (psychopathology, negative life events, etc.), and have lower weight loss than resilient patients.
Detailed description
The investigators will report the change of resilience during lifestyle/behavioral modifications program and 2 years after bariatric surgical treatment, and the investigators will describe the factors associated with this change: * History of trauma * Psychopathology (eating disorders, depression, anxiety, addiction) * Personality factors * Characteristic of psychotherapy
Interventions
None listed
Sponsors
Central Hospital, Nancy, France
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Severe obesity (BMI ≥35 kg/m2) * Candidate for Bariatric surgery at Nancy CSO (2016-2020) after a lifestyle/behavioral modifications program * Full psychological assessment data
Exclusion criteria
* Patient's opposition to the use of data for research purposes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Resilience (Questionnaire) : Resilience Scale for Adult (RSA) | baseline (T0) | Min: 33 ; Max: 231; Higher scores mean a better outcome Score of resilience (Resilience Scale for adults) and level of resilience (non-resilient, intermediate, resilient) / number of patients in each category |
| Resilience (semi-structured interview) : level of resilience | baseline (T0) | Categories : Non-resilient, intermediate, resilient Number and % of patients in each category |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Binge eating scale (BES) | baseline (T0) | Min: 0 ; Max: 48 ; Higher scores mean a worse outcome. |
| Mini International Neuropsychiatric Interview (semi-structured interview) | baseline (T0) | Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders). |
| Psychological trauma (semi-structured interview) | Baseline (T0) | Number and % of patients in each category (Sexual, physical, emotional abuse, emotional and physical neglect) Number and % of patients in each category for the first trauma (childhood, adolescence, adulthood) |
| Childhood Trauma Questionnaire (CTQ) | baseline (T0) | Min: 25 ; Max: 125 ; Higher scores mean a worse outcome |
| Toronto Alexithymia Scale (TAS) | baseline (T0) | Min: 20 ; Max: 100 ; Higher scores mean a worse outcome |
| Medical Outcomes Study Short Form (SF-36) | baseline (T0) | Min: 0 ; Max: 100 ; Higher scores mean a better outcome. |
| Definition of patient's psychological profile : clinical interviews | baseline (T0) | Profile is determined by clinical interviews |
| Definition of patient's psychological profile : Rorschach test | baseline (T0) | Profile is determined by Rorschach test |
| Characteristics of psychotherapy : Duration | baseline (T0) | Duration of psychotherapy (month) |
| Characteristics of psychotherapy : Frequency | baseline (T0) | Frequency of psychotherapy (number of sessions per month) |
| Characteristics of psychotherapy: Type of professional | baseline (T0) | Type of professional (Psychiatrist, Psychologist, Nurse, Other) |
| Hospital Anxiety and Depression scale (HAD) | baseline (T0) | Min: 0 ; Max: 42; Higher scores mean a worse outcome. |
| Sex | baseline (T0) | men/women |
| Age | baseline (T0) | years |
| Professional situation | baseline (T0) | Active / Unemployed / Homemaker / Retired / Unable to work |
| Family situation | baseline (T0) | Currently married/cohabiting / Formerly married / Never married |
| Weight data | baseline (T0) | Weight: kg BMI: kg/m² |
| Mini International Neuropsychiatric Interview | 10 months (T1) | • Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders). |
| Definition of patient's psychological profile :clinical interviews | 10 months (T1) | Profile is determined by clinical interviews |
| Characteristics of psychotherapy: Duration | 10 months (T1) | Duration of psychotherapy (month) |
| Characteristics of psychotherapy: Frequency | 10 months (T1) | Frequency of psychotherapy (number of sessions per month) |
| Characteristics of psychotherapy: Investment | 10 months (T1) | Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome. |
| Characteristics of psychotherapy : Investment | baseline (T0) | Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome. |
| Dutch Eating Behaviour Questionnaire (DEBQ) | baseline (T0) | Min: 33 ; Max: 165 ; Higher scores mean a worse outcome |
Countries
France
Outcome results
None listed