Feasibility and Clinical Usefulness of the Unified Protocol in Online Group Format for Bariatric Surgery Candidates: Study Protocol for a Multiple Baseline Experimental Design (original) (raw)
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Emotion regulation and mental well-being before and six months after bariatric surgery
Eating and weight disorders : EWD, 2017
According to the current state of research, mental health improves due to bariatric surgery. However, improvements in weight and psychosocial aspects often show a gradual decline with time. As emotion regulation (ER) appears to be a key variable in the successful outcome of weight loss treatments, the present study aimed at investigating ER-strategies applied by bariatric surgery candidates pre- and post-surgery and examining interactions between ER, depressive symptoms, health-related quality of life (HrQoL), and post-surgical weight loss. Prior to and 6 months after bariatric surgery, 45 patients (76% women) completed self-report questionnaires assessing depressive symptoms (Beck Depression Inventory-II), HrQoL (Short Form-36 Health Survey), and ER-strategies (Emotion Regulation Inventory for Negative Emotions). Six months post-surgery, the patients reported significant improvements in depressive symptomatology, HrQoL, and satisfaction with ER compared to pre-surgery. Groups diffe...
Emotion processing and regulation in women with morbid obesity who apply for bariatric surgery
Psychology & Health, 2012
Cognitive and emotional processes that promote and obstruct a successful outcome after bariatric surgery for morbid obesity Cognitieve en emotionele processen die een succesvolle uitkomst na bariatrische chirurgie voor morbide obesitas bevorderen en belemmeren (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof. dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op vrijdag 11 november 2011 des middags te 12.45 uur door Johanna Wilhelmina Zijlstra geboren op 1 mei 1963, te Amsterdam
Psychological Profile of Patients Eligible for Bariatric Surgery
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 2016
Background: The psychologist who works in bariatric surgery has a role to receive, evaluate, prepare and educate the patient who will undergo the surgical procedure. Psychological evaluation becomes important in so far as allows us to obtain data on personal and familiar history and allow tracing of possible psychopathology. Aim: To collect data on psychological evaluations of patients in a bariatric surgery service of a public hospital in order to describe the psychological profile of patients in this service. Method: Data were collected from 827 patients between 2001 and 2015, using data from an interview, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Binge Eating Scale (BES). Results: The mean age of patients before surgery was 39 years+/- 10, the mean BMI was 51 kg/m²+7, and most patients (81%) were female. The average score on the BDI was 14.8+8 and women had significantly higher scores than men. On the BAI the average score was 11+8 and on the ECAP was 14+8...
BMC Surgery
Background Adaptive cognitive emotion regulation (CER) strategies toward eating play a very important role in obesity and according to schema therapy, patients with obesity learn that don't respond to their emotional stimuli by eating. Thus, this study aimed to evaluate the effectiveness of an online video-based group schema therapy in improvement of the CER strategies and body mass index (BMI) in women who had undergone bariatric surgery. Methods Forty women who had undergone sleeve gastrectomy were selected and randomly divided into two groups of control and experimental. The experimental group received 10 weekly 90-min sessions of group schema therapy, the control group did not receive any intervention at all. Both groups completed the CER strategies questionnaire during pre-test, post-test and follow-up stages, and the data were analyzed using a multivariate analysis of covariance (MANCOVA) through SPSS software (version 20). Results Our results indicated that the experiment...
Obesity Surgery, 2011
Background Psychological and behavioural factors seem to influence the results of bariatric surgery and the ability to achieve sustained weight loss and subjective wellbeing after the operation. Adequate pre-and postoperative psychological counselling are suggested to improve the results of surgery. However, some patients are reluctant to participate in pre-and postoperative counselling. The aim of the present study was to investigate the possible influence of psychiatric disorders on willingness to participate in group counselling in patients accepted for bariatric surgery. Methods One hundred and forty-one patients referred to bariatric surgery (F/M: 103/38) with mean body mass index (BMI) of 45.2 kg/m 2 (SD=5.3) and mean age of 42.0 years (SD = 10.4) were interviewed with Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II) preoperatively.
Bariatric Nursing and Surgical Patient Care, 2009
Background: One important part of the pre-surgical mental health evaluation is to assess what, if any, emotional factors may be related to a patient's eating behavior. In this way, appropriate biopsychosocial interventions may be designed to facilitate their longterm maintenance of weight loss. The current investigation examined the role that negative emotional states might play in increased pre-surgical eating behavior in a sample of bariatric surgery patients.
Annals of Bariatrics and Metabolic Surgery
Due to resource limitations, psychological support for bariatric patients needs to be targeted to those most in need. This study aimed to evaluate the resource implications of a brief triage tool to identify and support those most at risk from poorer outcomes. Materials and methods: A four stage process was used involving: Expert consensus; the selection of appropriate measures; A patient cohort over two years; A resource analysis. Results: Three key psychological contra-indications for bariatric surgery were identified by expert psychologists (n=45) as alcohol and drug dependency and suicidality. Next, existing validated measures were selected based upon the literature to form the Bariatric Triage Tool (BTT) consisting of the AUDIT, DAST-10 and SBQ-R. Consecutive patients at one UK bariatric clinic then completed the BTT for 2 years (n=484). Of these under a fifth were identified as at risk (n=85; 17.6%) and referred for an in depth one to one assessment with a bariatric psychologist. Of these 7 (1.4%) were referred to their GP for further psychological support and removed from the surgical pathway. Finally, resource implications were evaluated and indicated that the BTT saved both money (between £15 and £105 per patient depending on the metric) and time (just under one hour per patient) which could be used to target those patients most in need of psychological support. Conclusion: The BTT is a brief, easy to self-administer tool that could be used to identify those most at risk and ensure that psychological support is targeted to those most in need.
Bariatric psychology in the UK National Health Service: input across the patient pathway
BMC Obesity, 2014
Background: Providers of bariatric surgery within the National Health Service (NHS) are required to provide psychological assessment and intervention, yet operational definitions regarding the purpose and scope of this input are lacking. This has led to significant variation in the provision of psychology, with some providing an assessment-only service and others providing a more comprehensive package of intervention throughout the patient pathway. The aims of this paper are to document the current psychology provision and service models of National Health Service (NHS) bariatric surgery services in the UK. Psychologists belonging to a bariatric psychology forum completed a survey. This focused on provision of psychological assessment and intervention throughout the bariatric pathway as well as the ratio between psychology resources and number of bariatric procedures per year. We obtained information from 22 NHS services which provide 3691 procedures per year. Results: There is significant variation in the ratio between psychology resources and number of bariatric procedures undertaken per service. Whilst all services offer pre-surgery psychology assessments, less than one-third routinely assess all potential bariatric surgery candidates. Over 90% of services offer pre-surgery individual interventions and 41% offer pre-surgery groups. None of the services routinely offer post-surgery assessments but 68% offer post-surgery assessment and intervention following referral. None offered post-operative structured psychological group interventions. Conclusion: There are significant disparities and inconsistencies in the provision of psychology resources in relation to surgery volume in the NHS. Most of these resources are directed at pre-surgery assessment and this raises issues regarding the function of these assessments. Rather than focusing on assessing psychological (un) suitability for surgery, an evidence-based approach involves psychologists offering pre-operative interventions to improve readiness for surgery and post-operative interventions to address recurring or emerging difficulties which impact on outcomes.
Frontiers in Psychology, 2018
Background: This study aims to evaluate long-term quality of life (QoL) and primary clinical outcomes, 10 years after biliointestinal bypass (BIB) surgery. It was expected that, although BIB might show encouraging primary outcomes, long term QoL could be significantly impaired. Methods: Ninety patients were contacted for a phone interview [age 41.0 ± 10.6 (mean ± SD) years, age-range 31-65 years]. QoL (by SF-36) and the clinical situation (by ad hoc questionnaire) were collected. Data were analyzed with SPSS 22. SF-36 scores were compared with Italian normative data from general and healthy population. We also compared primary clinical outcomes and SF-36 scores between patients who reported high and low levels of satisfaction with BIB. Results: Considering SF-36 results, patients showed significant impairments in QoL compared to general and healthy populations. Sixty-five percent would repeat the BIB. All patients showed at least one chronic adverse event. It occurred a significant decrease in pre-post co-occurrence rates of diabetes (χ 2 = 18.41; p < 0.001) and hypertension (χ 2 = 50.27; p < 0.001). Large and significant weight loss indexes (i.e., percent excess weight loss (%EWL); body mass index) were observed between pre-post intervention. Conclusion: BIB showed promising primary clinical outcomes (i.e., hypertension, diabetes, and weight loss). However, subjects reported a significant impairment in all SF-36 domains. Ad hoc psychological interventions should be implemented to ameliorate the quality of life of these patients.
Clinical versus patient-reported measures of depression in bariatric surgery
Surgical endoscopy, 2018
Bariatric surgery patients with mental illness may experience worse surgical outcomes compared to those without. Depression is the most prevalent mental health diagnosis amongst Americans with obesity. Accurate diagnosis and treatment is of paramount importance to mitigate perioperative risk. Unfortunately, there is no standard method to screen patients for depression prior to surgery. Our goal was to understand the relationship between traditional clinical screening tools and a novel patient-reported depression screening survey, Patient Health Questionnaire 8 (PHQ-8), in the setting of the bariatric surgery preoperative assessment. The study included all adult bariatric surgery patients from January 2014 through June 2016. Patients who were not assessed using both the PHQ-8 and a traditional clinical depression screening were excluded from the study. There were a total of 4486 patients who met the eligibility criteria and were included in analysis. We used comparative statistics to...