Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Archives of Clinical Psychiatry |
Texto Completo: | https://www.revistas.usp.br/acp/article/view/17352 |
Resumo: | BACKGROUND: In recent decades, several longitudinal studies show the efficacy of bariatric surgery on long-term weight control and reductions in mortality due to clinical complications associated with obesity. However, studies also show significantly increased mortality due to suicide and impulsive behavior, for reasons largely unknown, which demonstrates the paucity of information concerning the clinical management of bariatric patients. This study aims to synthesize the current state of knowledge regarding the psychiatric care of bariatric patients. METHOD: A selective review of literature involving articles indexed on Medline and PubMed up to June 2010, using the terms: "bariatric surgery", "psychiatry", "binge eating", "follow-up", and "outcome". RESULTS: The literature is somehow consensual in which there is no absolute psychiatric contraindication for bariatric surgery, although the preoperative evaluation is of extreme importance for the diagnosis and treatment of any psychiatric disorder, to assure adherence to the multidisciplinary approach, improved quality of life and possibly a better prognosis after surgery. Among the most prevalent disorders in this population is the binge-eating disorder (BED), which is associated with lower weight loss and poor quality of life, especially when present in the postoperative period. In the postoperative follow-up one should also be alert to the emergence of impulsive symptoms, including abuse of alcohol and other substances. DISCUSSION: Several studies indicate high prevalence of mental disorders and psychopathology in the population of bariatric patients. Although most patients experience adequate weight control and improved quality of life in the medium and long term, some patients develop abnormal behavior relating to dysfunctional eating patterns, abuse of alcohol and other substances, and complications associated with impulsive behavior, which suggests etiological hypotheses involving from neurochemistry to psychosocial theories. For all these reasons, it is of fundamental importance that mental health professionals to integrate the teams that evaluate and monitor the bariatric patients. |
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Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão Aspects of psychiatric care for obese patients under bariatric treatment: a review Obesidadecirurgia bariátricapsiquiatriatranstorno da compulsão alimentar periódicaObesitybariatric surgerypsychiatrybinge eating disorder BACKGROUND: In recent decades, several longitudinal studies show the efficacy of bariatric surgery on long-term weight control and reductions in mortality due to clinical complications associated with obesity. However, studies also show significantly increased mortality due to suicide and impulsive behavior, for reasons largely unknown, which demonstrates the paucity of information concerning the clinical management of bariatric patients. This study aims to synthesize the current state of knowledge regarding the psychiatric care of bariatric patients. METHOD: A selective review of literature involving articles indexed on Medline and PubMed up to June 2010, using the terms: "bariatric surgery", "psychiatry", "binge eating", "follow-up", and "outcome". RESULTS: The literature is somehow consensual in which there is no absolute psychiatric contraindication for bariatric surgery, although the preoperative evaluation is of extreme importance for the diagnosis and treatment of any psychiatric disorder, to assure adherence to the multidisciplinary approach, improved quality of life and possibly a better prognosis after surgery. Among the most prevalent disorders in this population is the binge-eating disorder (BED), which is associated with lower weight loss and poor quality of life, especially when present in the postoperative period. In the postoperative follow-up one should also be alert to the emergence of impulsive symptoms, including abuse of alcohol and other substances. DISCUSSION: Several studies indicate high prevalence of mental disorders and psychopathology in the population of bariatric patients. Although most patients experience adequate weight control and improved quality of life in the medium and long term, some patients develop abnormal behavior relating to dysfunctional eating patterns, abuse of alcohol and other substances, and complications associated with impulsive behavior, which suggests etiological hypotheses involving from neurochemistry to psychosocial theories. For all these reasons, it is of fundamental importance that mental health professionals to integrate the teams that evaluate and monitor the bariatric patients. CONTEXTO: Nas últimas décadas, diversos estudos longitudinais têm demonstrado a eficácia da cirurgia bariátrica no controle de peso em longo prazo e na redução da mortalidade resultante de complicações clínicas associadas à obesidade. Contudo, os estudos também revelam aumento significativo da mortalidade devida a suicídio e comportamento impulsivo, por razões largamente desconhecidas, o que demonstra a escassez de informações relativas ao manejo clínico de pacientes bariátricos. O presente estudo tem como objetivo sintetizar o estado atual de conhecimentos referentes ao acompanhamento psiquiátrico de pacientes bariátricos. MÉTODO: Revisão seletiva da literatura envolvendo artigos indexados no Medline e PubMed até junho de 2010, utilizando-se os termos: "bariatric surgery", "psychiatry", "binge eating", "follow-up" e "outcome". RESULTADOS: Há relativo consenso na literatura de que não haja contraindicação psiquiátrica absoluta para a cirurgia bariátrica, embora a avaliação pré-operatória seja de extrema importância para o diagnóstico e tratamento de eventuais transtornos psiquiátricos, objetivando assegurar aderência ao tratamento multidisciplinar, melhor qualidade de vida e, possivelmente, melhor prognóstico pós-cirúrgico. Entre os transtornos mais prevalentes nessa população, encontra-se o transtorno da compulsão alimentar periódica (TCAP), que está relacionado com menor perda ponderal e pior qualidade de vida, especialmente quando presente no pós-operatório. No acompanhamento pós-operatório, também se deve atentar para o surgimento de sintomas impulsivos, incluindo abuso de álcool e outras substâncias. CONCLUSÃO: Diversos estudos indicam elevada prevalência de transtornos mentais e alterações psicopatológicas na população de pacientes bariátricos. Embora a maioria dos pacientes apresente adequado controle ponderal e melhora na qualidade de vida em médio e longo prazo, alguns pacientes desenvolvem alterações relativas ao comportamento alimentar, abuso de álcool e outras substâncias e complicações associadas a comportamento impulsivo, o que remete a hipóteses etiológicas que vão desde modelos neuroquímicos até teorias psicossociais. Por todas essas razões, é de fundamental importância que os profissionais de saúde mental integrem as equipes que avaliam e acompanham os pacientes bariátricos. Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria2011-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/acp/article/view/1735210.1590/S0101-60832011000400007Revista de Psiquiatria Clínica; Vol. 38 Núm. 4 (2011); 148-154Archives of Clinical Psychiatry; v. 38 n. 4 (2011); 148-154Archives of Clinical Psychiatry; Vol. 38 No. 4 (2011); 148-1541806-938X0101-6083reponame:Archives of Clinical Psychiatryinstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/acp/article/view/17352/19382Gordon, Pedro C.Kaio, Glauber H.Sallet, Paulo C.info:eu-repo/semantics/openAccess2012-09-25T20:34:54Zoai:revistas.usp.br:article/17352Revistahttp://www.hcnet.usp.br/ipq/revista/index.htmlPUBhttps://old.scielo.br/oai/scielo-oai.php||archives@usp.br1806-938X0101-6083opendoar:2012-09-25T20:34:54Archives of Clinical Psychiatry - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão Aspects of psychiatric care for obese patients under bariatric treatment: a review |
title |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão |
spellingShingle |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão Gordon, Pedro C. Obesidade cirurgia bariátrica psiquiatria transtorno da compulsão alimentar periódica Obesity bariatric surgery psychiatry binge eating disorder |
title_short |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão |
title_full |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão |
title_fullStr |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão |
title_full_unstemmed |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão |
title_sort |
Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão |
author |
Gordon, Pedro C. |
author_facet |
Gordon, Pedro C. Kaio, Glauber H. Sallet, Paulo C. |
author_role |
author |
author2 |
Kaio, Glauber H. Sallet, Paulo C. |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Gordon, Pedro C. Kaio, Glauber H. Sallet, Paulo C. |
dc.subject.por.fl_str_mv |
Obesidade cirurgia bariátrica psiquiatria transtorno da compulsão alimentar periódica Obesity bariatric surgery psychiatry binge eating disorder |
topic |
Obesidade cirurgia bariátrica psiquiatria transtorno da compulsão alimentar periódica Obesity bariatric surgery psychiatry binge eating disorder |
description |
BACKGROUND: In recent decades, several longitudinal studies show the efficacy of bariatric surgery on long-term weight control and reductions in mortality due to clinical complications associated with obesity. However, studies also show significantly increased mortality due to suicide and impulsive behavior, for reasons largely unknown, which demonstrates the paucity of information concerning the clinical management of bariatric patients. This study aims to synthesize the current state of knowledge regarding the psychiatric care of bariatric patients. METHOD: A selective review of literature involving articles indexed on Medline and PubMed up to June 2010, using the terms: "bariatric surgery", "psychiatry", "binge eating", "follow-up", and "outcome". RESULTS: The literature is somehow consensual in which there is no absolute psychiatric contraindication for bariatric surgery, although the preoperative evaluation is of extreme importance for the diagnosis and treatment of any psychiatric disorder, to assure adherence to the multidisciplinary approach, improved quality of life and possibly a better prognosis after surgery. Among the most prevalent disorders in this population is the binge-eating disorder (BED), which is associated with lower weight loss and poor quality of life, especially when present in the postoperative period. In the postoperative follow-up one should also be alert to the emergence of impulsive symptoms, including abuse of alcohol and other substances. DISCUSSION: Several studies indicate high prevalence of mental disorders and psychopathology in the population of bariatric patients. Although most patients experience adequate weight control and improved quality of life in the medium and long term, some patients develop abnormal behavior relating to dysfunctional eating patterns, abuse of alcohol and other substances, and complications associated with impulsive behavior, which suggests etiological hypotheses involving from neurochemistry to psychosocial theories. For all these reasons, it is of fundamental importance that mental health professionals to integrate the teams that evaluate and monitor the bariatric patients. |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/acp/article/view/17352 10.1590/S0101-60832011000400007 |
url |
https://www.revistas.usp.br/acp/article/view/17352 |
identifier_str_mv |
10.1590/S0101-60832011000400007 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/acp/article/view/17352/19382 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Medicina. Instituto de Psiquiatria |
dc.source.none.fl_str_mv |
Revista de Psiquiatria Clínica; Vol. 38 Núm. 4 (2011); 148-154 Archives of Clinical Psychiatry; v. 38 n. 4 (2011); 148-154 Archives of Clinical Psychiatry; Vol. 38 No. 4 (2011); 148-154 1806-938X 0101-6083 reponame:Archives of Clinical Psychiatry instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Archives of Clinical Psychiatry |
collection |
Archives of Clinical Psychiatry |
repository.name.fl_str_mv |
Archives of Clinical Psychiatry - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||archives@usp.br |
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1787713903066611712 |