Bulle Gaudrat1,2, Séverine Andrieux3, Vincent Florent3, Amélie Rousseau4. 1. PSITEC Lab EA 4072, University of Lille, Domaine du Pont de Bois, BP 60149, 59653, Villeneuve d'Ascq Cedex, France. bulle.gaudrat@ch-arras.fr. 2. Nutrition Department, Arras General Hospital, 3, Boulevard Georges Besnier, CS 90006, 62022, Arras, France. bulle.gaudrat@ch-arras.fr. 3. Nutrition Department, Arras General Hospital, 3, Boulevard Georges Besnier, CS 90006, 62022, Arras, France. 4. PSITEC Lab EA 4072, University of Lille, Domaine du Pont de Bois, BP 60149, 59653, Villeneuve d'Ascq Cedex, France.
Abstract
PURPOSE: Bariatric surgery (BS) is considered the most effective treatment for severe obesity. Nevertheless, long-term studies have identified some concerning issues, such as increased postoperative rates of suicide and substance use disorders. Some investigators have postulated that these postoperative issues might result from differences in psychological characteristics between patients with obesity seeking BS and those seeking non-surgical (medical) care. The aim of this study was to explore the psychological differences between patients seeking BS and those seeking non-surgical care. METHODS: 151 patients seeking BS (BS group) and 95 patients seeking medical care (non-surgery group) completed questionnaires measuring depression, anxiety, self-esteem, body dissatisfaction, hopelessness and weight-loss expectations (WLE). RESULTS: There were no differences between the BS and non-surgery groups in depression, anxiety or self-esteem. Body dissatisfaction and WLE were greater in the BS group than in the non-surgery group. Contrary to our hypothesis, the non-surgery group showed higher levels of hopelessness than the BS group. Correlation analyses revealed very similar associations between psychological characteristics for both groups. Hierarchical regression and moderation analyses identified self-esteem as the factor most predictive of hopelessness in both groups. CONCLUSIONS: We found few differences in psychological characteristics between groups. The lower level of hopelessness in the BS group might be seen as a form of protection leading up to surgery but may result from the patient's view of BS as their "last best hope". Further studies are needed to understand the evolution of these psychological characteristics after surgery and their possible effects on postoperative outcomes. LEVEL OF EVIDENCE: Level III, case-control analytic studies.
PURPOSE: Bariatric surgery (BS) is considered the most effective treatment for severe obesity. Nevertheless, long-term studies have identified some concerning issues, such as increased postoperative rates of suicide and substance use disorders. Some investigators have postulated that these postoperative issues might result from differences in psychological characteristics between patients with obesity seeking BS and those seeking non-surgical (medical) care. The aim of this study was to explore the psychological differences between patients seeking BS and those seeking non-surgical care. METHODS: 151 patients seeking BS (BS group) and 95 patients seeking medical care (non-surgery group) completed questionnaires measuring depression, anxiety, self-esteem, body dissatisfaction, hopelessness and weight-loss expectations (WLE). RESULTS: There were no differences between the BS and non-surgery groups in depression, anxiety or self-esteem. Body dissatisfaction and WLE were greater in the BS group than in the non-surgery group. Contrary to our hypothesis, the non-surgery group showed higher levels of hopelessness than the BS group. Correlation analyses revealed very similar associations between psychological characteristics for both groups. Hierarchical regression and moderation analyses identified self-esteem as the factor most predictive of hopelessness in both groups. CONCLUSIONS: We found few differences in psychological characteristics between groups. The lower level of hopelessness in the BS group might be seen as a form of protection leading up to surgery but may result from the patient's view of BS as their "last best hope". Further studies are needed to understand the evolution of these psychological characteristics after surgery and their possible effects on postoperative outcomes. LEVEL OF EVIDENCE: Level III, case-control analytic studies.
Entities:
Keywords:
Bariatric surgery; Hopelessness; Medical care; Psychopathology; Suicide
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