ÖZET
Amaç:
Bu çalışmanın amacı bariatrik cerrahi geçiren hastalarda gözlenen depresyon ve beden algısı değişimlerini ortaya koymaktır.
Yöntemler:
Prospektif çalışma tanımlayıcı ve ilişki arayıcı niteliktedir. Bariatrik cerrahi geçiren hastaların depresyon belirti düzeyi ve beden algısının sürece bağlı değerlendirilmesi amacıyla bir üniversite hastanesinin genel cerrahi kliniğinde yatan hastalar çalışma evrenini oluşturmuştur. Örneklemi ise aynı hastanenin genel cerrahi kliniğinde; 18 yaşından büyük, yönelimi tam (zaman, kişi, yer) ve bilinci açık, görebilen, işitebilen, Türkçeyi okuma, yazma, konuşabilme ve anlayabilme becerisine sahip, obezite tanısı konmuş, ameliyat olmak üzere hastaneye yatırılmış ve araştırmaya katılmayı kabul eden 22 hasta oluşturmuştur. Çalışma verileri Kişisel Bilgi Formu ile beden algısı ölçeği (BAÖ) ve beck depresyon ölçeği (BDÖ) kullanılarak toplanmıştır.
Bulgular:
Çalışma yaş ortalaması 31,18±7,79 yıl olan 16’sı kadın 22 hasta üzerinde gerçekleştirildi. Ameliyattan bir yıl sonraki beden kütle indeksi (BKİ) (kg/m2) değerleri, ilk değerlendirmeye göre anlamlı ölçüde daha düşüktür (Z=-4,107; p=0,000). Ameliyattan bir yıl sonraki BAÖ puan ortalamaları, ilk değerlendirmeye göre anlamlı ölçüde daha düşüktür (t=3,447; p=0,002). Ön test BKİ (kg/m2) ile BDÖ skoru arasında pozitif yönde, zayıf derecede istatistiksel olarak anlamlı ilişki tespit edilmiştir (r=0,448; p=0,036). BKİ (kg/m2) arttıkça ön test BDÖ puanları artmış aynı şekilde, BKİ (kg/m2) azaldıkça, ön test BDÖ puanları azalmıştır.
Sonuç:
Hastaların bariatrik cerrahiden bir yıl sonra önemli bir kilo kaybı yaşadığı, ameliyat öncesi sınırda klinik depresyonun veya orta düzey depresyonun, bir yıl sonra hafif depresyon olarak değişim gösterdiği ve bariatrik cerrahinin beden algısını olumlu yönde etkilediği belirlendi.
References
1
World Health Organization. Obesity and overweight. 2021. Erişim adresi: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
2
Türkiye Endokrinoloji ve Metabolizma Derneği. Bariyatrik Cerrahi Kılavuzu. Ankara, 2019. https://file.temd.org.tr/Uploads/publications/guides/documents/20190527160325-2019tbl_kilavuza1dab037d3.pdf
3
T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Obezite Nedir? Erişim Adresi: https://hsgm.saglik.gov.tr/tr/obezite/obezite-nedir.html. Erişim Tarihi:21.04.2021
4
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017;390:2627-42.
5
Müller A, Hase C, Pommnitz M, de Zwaan M. Depression and Suicide After Bariatric Surgery. Curr Psychiatry Rep 2019;21:84.
6
De Lorenzo A, Gratteri S, Gualtieri P, Cammarano A, Bertucci P, Di Renzo L. Why primary obesity is a disease? J Transl Med 2019;17:169.
7
Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju ShN, Wormser D, Gao P, Kaptoge S, et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016;388:776-86.
8
Arhi CS, Dudley R, Moussa O, Ardissino M, Scholtz S, Purkayastha S. The Complex Association Between Bariatric Surgery and Depression: a National Nested-Control Study. Obes Surg 2021;31:1994-2001.
9
Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, et al. Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ 2013;347:f5934.
10
O’Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg 2019;29:3-14.
11
Khosravi-Largani M, Nojomi M, Aghili R, Otaghvar HA, Tanha K, Seyedi SHS, et al. Evaluation of all Types of Metabolic Bariatric Surgery and its Consequences: a Systematic Review and Meta-Analysis. Obes Surg 2019;29:651-90.
12
Kalarchian MA, Marcus MD. Psychosocial Concerns Following Bariatric Surgery: Current Status. Curr Obes Rep 2019;8:1-9. Erratum in: Curr Obes Rep 2019.
13
De Luca M, Angrisani L, Himpens J, Busetto L, Scopinaro N, Weiner R, et al. Indications for Surgery for Obesity and Weight-Related Diseases: Position Statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg 2016;26:1659-96.
14
Booth H, Khan O, Prevost AT, Reddy M, Charlton J, Gulliford MC, et al. Impact of bariatric surgery on clinical depression. Interrupted time series study with matched controls. J Affect Disord 2015;174:644-9.
15
Sevinçer GM. Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline. Anatolian Journal of Psychiatry 2016;17:5-45.
16
Collins JC, Bentz JE. Behavioral and psychological factors in obesity. The Journal of Lancaster General Hospital 2009;4:124-7.
17
Gill H, Kang S, Lee Y, Rosenblat JD, Brietzke E, Zuckerman H, et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord 2019;246:886-94.
18
de Zwaan M, Enderle J, Wagner S, Mühlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews. J Affect Disord 2011;133:61-8.
19
Burgmer R, Legenbauer T, Müller A, de Zwaan M, Fischer C, Herpertz S. Psychological outcome 4 years after restrictive bariatric surgery. Obesity surgery 2014;24:1670-8.
20
Yatsuya H, Li Y, Hilawe EH, Ota A, Wang C, Chiang C, et al. Global trend in overweight and obesity and its association with cardiovascular disease incidence. Circ J 2014;78:2807-18.
21
Franssens BT, Hoogduin H, Leiner T, van der Graaf Y, Visseren FLJ. Relation between brown adipose tissue and measures of obesity and metabolic dysfunction in patients with cardiovascular disease. J Magn Reson Imaging 2017;46:497-504.
22
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:766-81. Erratum in: Lancet 2014;384:746.
23
Major P, Matłok M, Pędziwiatr M, Migaczewski M, Budzyński P, Stanek M, et al. Quality of Life After Bariatric Surgery. Obes Surg 2015;25:1703-10.
24
Secord PF, Jourard SM. The appraisal of body-cathexis: body cathexis and the self. J Consult Psychol 1953;17:343-7.
25
Hovardaoğlu S. Body cathexis scale. psychiatry, psychology. Journal of Psychopharmacology 1993;1:26-7.
26
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-71.
27
Hisli N. Reliability and validity of the beck depression inventory for college students. Turkish Journal of Psychology 1989;7:3-13.
28
Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142:547-59.
29
Geller S, Dahan S, Levy S, Goldzweig G, Hamdan S, Abu-Abeid S. Body Image and Emotional Eating as Predictors of Psychological Distress Following Bariatric Surgery. Obes Surg 2020;30:1417-23.
30
Lin HY, Huang CK, Tai CM, Lin HY, Kao YH, Tsai CC, et al. Psychiatric disorders of patients seeking obesity treatment. BMC Psychiatry 2013;13:1.
31
Teufel M, Rieber N, Meile T, Giel KE, Sauer H, Hünnemeyer K, et al. Body image after sleeve gastrectomy: reduced dissatisfaction and increased dynamics. Obes Surg 2012;22:1232-7.
32
Jensen JF, Petersen MH, Larsen TB, Jørgensen DG, Grønbaek HN, Midtgaard J. Young adult women’s experiences of body image after bariatric surgery: a descriptive phenomenological study. J Adv Nurs 2014;70:1138-49.
33
Song P, Patel NB, Gunther S, Li CS, Liu Y, Lee CY, et al. Body Image & Quality of Life: Changes With Gastric Bypass and Body Contouring. Ann Plast Surg 2016;76 Suppl 3(Suppl 3):S216-21.
34
Hamurcu P, Öner C, Telatar B, Yeşildağ Ş. The impact of obesity on self-esteem and body image. Turkish Journal of Family Medicine 2015;19:122–8.
35
Allen D, Belcher HM, Young A, Gibson LW, Colantuoni E, Trent M. BMI, Body Image, Emotional Well-Being and Weight-Control Behaviors in Urban African American Adolescents. Int J Child Health Nutr 2016;5:55-104.
36
Bȩtkowska-Korpała B, Ćwiȩk A, Izydorczyk B, Starowicz-Filip A, Major P. Predictive Role of Body Image in Bulimic Behaviors Among Obese Patients Qualified for Bariatric Surgery. Front Psychiatry 2021;12:781323.
37
Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, et al. Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery: A Meta-analysis. JAMA 2016;315:150-63.
38
Mühlhans B, Horbach T, de Zwaan M. Psychiatric disorders in bariatric surgery candidates: a review of the literature and results of a German prebariatric surgery sample. Gen Hosp Psychiatry 2009;31:414-21.
39
Mitchell JE, Selzer F, Kalarchian MA, Devlin MJ, Strain GW, Elder KA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis 2012;8:533-41.
40
Faulconbridge LF, Bechtel CF. Depression and Disordered Eating in the Obese Person. Curr Obes Rep 2014;3:127-36.
41
Thonney B, Pataky Z, Badel S, Bobbioni-Harsch E, Golay A. The relationship between weight loss and psychosocial functioning among bariatric surgery patients. Am J Surg 2010;199:183-8.
42
van Strien T, Konttinen H, Homberg JR, Engels RC, Winkens LH. Emotional eating as a mediator between depression and weight gain. Appetite 2016;100:216-24.
43
Beaulac J, Sandre D. Impact of a CBT psychotherapy group on post-operative bariatric patients. Springerplus 2015;4:764.
44
Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010;67:220-9.
