RESUMEN
Bariatric surgery has proven to be the most effective treatment for severe obesity. Weight loss and long-term maintenance depend on patients ability to implement permanent lifestyle changes. Presurgical psychological evaluation and intervention are proposed for a better post surgical prognosis. The aim of present study was to make a psychosocial profile with the results of psychological evaluation performed to 129 bariatric surgery candidates and to determine associations between psychological variables with obesity level. Patients were evaluated with an oral interview, the MINI International Neuropsychiatric Interview, and the following self-reported instruments: Beck Depression Inventory, Anxiety Sensitivity Inventory, Stress Control Perception, Risk Factors related to Eating Behavior Disorders Scale, Quality of Life and Health Inventory. Study population was divided in groups according to obesity level, evaluation results were compared according to these groups. Results in present study show a high prevalence of psychiatric disorders; obesity level was not directly associated with level of psychopathology. Another finding is that at higher level of obesity, there is less concern about weight and food and also there is a significant higher perception of family support. The group of patients with higher concerns about weight and food had lower BMI and less perception of family support (AU)
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Asunto(s)
Humanos , Cirugía Bariátrica/psicología , Obesidad/psicología , Estudios Transversales , Índice de Masa Corporal , Apoyo SocialRESUMEN
BACKGROUND: Child psychopathology can e understood as normal development gone awry. Attention to psychosocial and behavioural problems has long been recommended as a critical component of well-child care. Likewise, screening for emotional and behavioural problems has been recommended as a routine part of health supervision visits. Different screening instruments have been developed and are widely used. Most of them include a dimensional measurement for internalizing, externalizing, and attention problems, but there is also the need to develop screening algorithms for specific psychiatric syndromes. OBJECTIVE: To present the concurrent validity and efficiency indicators of the Brief Screening and Diagnostic Questionnaire, CBTD, in a primary care health center (PCHC) at Mexico City, as a tool for the surveillance of mental health on children and adolescents. MATERIALS AND METHOD: A sample of 667 consecutive patients (4-16 years old) whose parents responded the CBTD. All patients who obtained a score of five or more symptoms were clinically interviewed using the MINI-KID, together with one of every ten subjects with a lower score. RESULTS: Efficiency showed a sensitivity of 68%, specificity of 82%, positive predictive value (PPV) of 88% and a negative predictive value (NPV) of 57%. When two or more CBTD syndromes are present the PPV is almost 100%. Concurrent validity showed a fair agreement for most of the CBTD syndromes as compared to DSM-IV diagnoses. Syndromes suggesting brain abnormalities, not included in scales of other widely used screening instruments, showed a PPV of 92% and NPV of 96.4%. CONCLUSIONS: The screening results from the CBTD can be used either categorically or dimensionally facilitating the surveillance of mental health on children and adolescents as different syndromatic profiles can be identified and followed for evaluation, along with complementary familial and psychosocial information.
