ABSTRACT
Introducción: La obesidad y la salud mental (SM) pueden interactuar de forma compleja y bidireccionalmente. Entre los tratamientos para la obesidad, la cirugía de pérdida de peso (WLS por sus siglas en inglés) es una alternativa para un número creciente de pacientes. El objetivo de este trabajo es realizar una revisión actualizada de los diversos aspectos que relacionan la SM y la WLS. Métodos: Se realizó una búsqueda en PubMed, utilizando los términos MeSH «mental health¼, «obesity¼,«surgery¼, «weight loss surgery¼, y «weight loss surgery¼ y «suicide¼, obteniéndose 532 resultados. Resultados: Los principales resultados fueron: a) Diversos equipos evalúan la SM de candidatos pre-WLS con diferentes procedimientos y protocolos. b) Hasta el 50% de los pacientes en evaluación pre-WLS tiene una enfermedad mental activa. c) La evidencia de que la presencia de alteraciones de la SM afecta el peso post-WLS no es concluyente. d) La investigación de pacientes con trastornos psiquiátricos severos sometidos a WLS es muy escasa y suele considerarse incluso un criterio de exclusión. e) La WLS se asoció a un impacto positivo en SM, ya sea por mejoría en la calidad de vida, por reducción en la severidad de trastornos mentales o por mejoría en las funciones cognitivas. Conclusiones: Los pacientes candidatos a WLS suelen sufrir de patología mental. La WLS se asocia a la mejoría de diversos resultados en SM. Nuevos estudios deben determinar si la presencia de algunos trastornos mentales y/o deterioro cognitivo podrían convertirse en criterios para la indicación de WLS.
Introduction: A complex interaction exists between mental health (MH) and obesity. Weight loss surgery (WLS) is currently an alternative for a growing number of patients. Hence, the aim of this study is to do an up-to-date review of the several aspects on the relationship between WLS and MH. Methods: A comprehensive PubMed search was done, using the MeSH terms ‘mental health’, ‘obesity’, ‘surgery’, and ‘weight loss surgery’ and ‘weight loss surgery’ and ‘suicide’. A total of 532 papers were found. Results: The main results were: a) Teams across the world evaluate MH of WLS candidates with different methods and protocols. b) Up to 50% of the patients in evaluation for WLS have an active mental disorder. c) The evidence that MH affects the final weight outcome in WLS subjects is not conclusive. d) The research in severe psychiatric patients and WLS is scarce and is often considered as an exclusion criterion. e) WLS is associated with a positive impact on MH, either due to a better quality of life, to reductions on the severity of mental disorders or improvements in cognitive functions. Conclusions: WLS seems to be associated with several positive outcomes of MH. Future studies should explore the questions yet not answered on this relationship, and investigate if the presence of some mental disorders and/or cognitive impairment might become criteria for the indication of WLS.
Subject(s)
Humans , Bariatric Surgery/psychology , Mental Health , Obesity/surgery , Quality of LifeABSTRACT
Background: There is a paucity of information on the perception of patients about ethical issues in medical practice. Aim: To determine the type and frequency of ethical problems perceived by patients hospitalized in public and private hospitals. Material and methods: Eighty eight subjects aged 65years (48 percent women), admitted to a public hospital and 44 subjects aged 59 years (52 percent women) admitted to a private clinic answered a survey about ethical problems. The main issues covered were medical information management, participation in decision making and intimacy of patients. Results: Fifty three percent of patients perceived at least one ethical problem. Patients admitted to the public hospital perceived more communication and intimacy problems than their peers admitted to a private clinic. Conclusions: Approximately half of the interviewed patients acknowledged the presence of ethical problems, especially in the communication and intimacy areas).