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Bozbulut R, Soysal Acar AŞ, Döğer E, Orhun Çamurdan M, Bideci A. The relationship between alexithymia, health literacy, and diet quality in obese adolescents. J Pediatr Endocrinol Metab 2023; 36:137-146. [PMID: 36588297 DOI: 10.1515/jpem-2022-0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/05/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Alexithymia and low health literacy are the barriers of self-management. This study aims to examine the relationship between alexithymia, health literacy and diet quality in obese adolescents, and their effects on anthropometric and biochemical markers. METHODS The 20-item Toronto alexithymia scale (TAS-20) was used to determine the alexithymic traits of the adolescents, and "The Newest Vital Sign" (NVS) scales were used to determine their health literacy levels. Diet quality was evaluated with the Healthy Eating Index-2010 (HEI-2010). RESULTS 39.7% of the obese adolescents were alexithymic, and 69.4% of alexithymics and 35.1% of non-alexithymics had metabolic syndrome. Alexithymic adolescents were lack of adequate health literacy. There were positive correlations between alexithymia scores and insulin, triglyceride, systolic and diastolic blood pressure levels, and all anthropometric values except height (p<0.05). There was a negative correlation between alexithymia scores and health literacy scores (p<0.05). There were negative correlations between health literacy and alexithymia scores, insulin, total cholesterol, triglyceride, ALT, systolic, diastolic blood pressure levels and all anthropometric values except height, and positive correlation was observed between health literacy scores and diet quality (p<0.05). Total HEI score was negatively correlated with waist circumference, neck circumference, body weight, BMI, triglyceride, AST, ALT, systolic and diastolic blood pressure, and positively correlated with health literacy and HDL levels (p<0.05). CONCLUSIONS As alexithymia severity increased in obese adolescents, the degree of obesity and the incidence of metabolic syndrome increased while the level of health literacy decreased. The increase in health literacy levels, on the other hand, decreased the level of alexithymia and increased the quality of the diet.
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Affiliation(s)
- Rukiye Bozbulut
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| | | | - Esra Döğer
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| | - Mahmut Orhun Çamurdan
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
| | - Aysun Bideci
- Faculty of Medicine, Department of Pediatric Endocrinology, Gazi University, Ankara, Türkiye
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Obesity and Psychological Factors Associated with Weight Loss after Bariatric Surgery: A Longitudinal Study. Nutrients 2022; 14:nu14132690. [PMID: 35807869 PMCID: PMC9268521 DOI: 10.3390/nu14132690] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023] Open
Abstract
Bariatric surgery is indicated for treatment of severely obese people and can lead to significant weight loss as well as reduction of comorbidities associated with obesity. The present study aims to investigate the relationship between different psychological factors (e.g., tendency to binge eating, impulsivity, alexithymia), adherence to the nutritional plan, and weight loss after bariatric surgery. Forty-five candidates for bariatric surgery accessing a center for the care of obesity were assessed at T0 (pre-surgery) and T1 (6 months post-surgery) through anthropometric and psychometric measures. Simple linear correlations and linear regressions were conducted to evaluate the relationship between the psychological variables, adherence to nutritional plan, and weight loss 6 months after bariatric surgery. Non-planning impulsivity was the principal factor that succeeded in explaining adherence to the diet plan among all the variables considered. Adherence to the nutritional plan and non-planning impulsivity were considered reliable short-term predictors of weight loss after bariatric surgery. This evidence explains the usefulness of promoting research on psychological predictors of outcome in bariatric surgery. Mid- and long-term weight maintenance and quality of life need to be investigated through further follow-up.
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Fanton S, Azevedo LC, Vargas DM. Alexithymia in obese adolescents is associated with severe obesity and binge eating behavior. J Pediatr (Rio J) 2022; 98:264-269. [PMID: 34273272 PMCID: PMC9432034 DOI: 10.1016/j.jped.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To study the occurrence of alexithymia in obese adolescents. METHODS Cross-sectional study with 102 obese adolescents. Sociodemographic, clinical, and psychometric data (alexithymia and binge eating) were analyzed The Brazilian version of the Toronto Alexithymia Scale and Binge Eating Scale were used for psychometric data collection. Statistical analysis was performed using the Kolmogorov-Smirnov test, Student's t-test, ANOVA, chi-square, linear regression, and logistic regression. The study was approved by Research Ethics Committee. RESULTS A 22% occurrence of alexithymia was observed. Considering the category "possible alexithymia", half of the participants presented some alexithymic behavior. Adolescents with alexithymia had higher binge eating scores (alexithymia 16,2 versus possible alexithymia 11,7 versus no alexithymia 8,5; ANOVA p < 0,0005) and three times more binge eating behavior than adolescents with no alexithymia or possible alexithymia (alexithymia 36.4% versus 17.2% possible alexithymia versus 11.8% no alexithymia; chi-square = 6,2, p = 0.04). In simple linear regression, alexithymia scores were positively associated with binge eating scores (r2 = 0,4; p = 0,002). Binary logistic regression showed a three times higher probability of an adolescent with severe obesity to meet the criteria for alexithymia. CONCLUSIONS There was a 22% occurrence of alexithymia in obese adolescents. It was positively associated with obesity severity and higher binge eating scores, suggesting a relationship between severe obesity, alexithymia, and binge eating behavior.
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Affiliation(s)
- Susane Fanton
- Universidade de Blumenau, Centro de Ciência da Saúde, Programa de Pós-graduação em Saúde Coletiva, Blumenau, SC, Brazil
| | - Luciane Coutinho Azevedo
- Universidade de Blumenau, Centro de Ciência da Saúde, Programa de Pós-graduação em Saúde Coletiva, Blumenau, SC, Brazil
| | - Deisi Maria Vargas
- Universidade de Blumenau, Centro de Ciência da Saúde, Programa de Pós-graduação em Saúde Coletiva, Blumenau, SC, Brazil.
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El Archi S, Brunault P, De Luca A, Cortese S, Hankard R, Bourbao-Tournois C, Ballon N, Réveillère C, Barrault S. Do Emotion Dysregulation, Alexithymia and Personality Dimensions Explain the Association Between Attention-Deficit/Hyperactivity Disorder and Binge Eating Among Bariatric Surgery Candidates? Front Psychol 2021; 12:745857. [PMID: 34867628 PMCID: PMC8641657 DOI: 10.3389/fpsyg.2021.745857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Addictive-like eating and attention-deficit/hyperactivity disorder (ADHD) are both common among persons seeking treatment for severe obesity. Given that ADHD and addictive-like eating, especially binge eating (BE) and food addiction (FA), are both strongly associated with personality dimensions and emotion dysregulation, it is possible emotional and personality characteristics contribute to the link between addictive-like eating behaviors and ADHD in people with severe obesity. This study aimed to investigate the psychological factors associated with BE and FA in bariatric surgery candidates, and to explore the mediational role of emotional factors (emotion dysregulation and alexithymia) and personality dimensions in the association between ADHD and BE. Method: Two hundred and eighty-two (n = 282) bariatric surgery candidates were recruited during the systematic preoperative psychiatric assessment (University Hospital of Tours, France). We assessed significant BE (Binge Eating Scale), probable adult ADHD (Wender Utah Render Scale and Adult ADHD Self-Report Scale), FA (Yale Food Addiction Scale 2.0, YFAS 2.0), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), alexithymia (Toronto Alexithymia Scale-20) and personality dimensions (Big Five Inventory). Mediation analyses were performed using the PROCESS macro for IBM SPSS Statistics 22. Results: Prevalence of probable adult ADHD, significant BE and FA were 8.2, 19.1, and 26.6%, respectively. Participants who screened positive for addictive-like eating showed higher prevalence of probable adult ADHD, as well as higher scores on adult and childhood ADHD symptoms. They also reported lower conscientiousness, but higher emotion dysregulation, higher alexithymia, and higher neuroticism. Only BE (as opposed to FA) was also associated with lower scores on agreeableness and openness. Analysis of the association between adult ADHD and BE suggests that emotion dysregulation, conscientiousness, agreeableness, and neuroticism are total mediators and alexithymia a partial mediator. Conclusion: Our findings suggest a significant association between ADHD and addictive-like eating among bariatric surgery candidates, and also suggest a significant role of emotion dysregulation and personality dimensions in this association. For individuals with ADHD and obesity, eating may be a way to cope with negative emotions, potentially increasing the risk for addictive-like eating behavior.
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Affiliation(s)
| | - Paul Brunault
- Qualipsy, EE 1901, Université de Tours, Tours, France.,CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France.,INSERM U1253 Imagerie et Cerveau (iBrain), Tours, France
| | - Arnaud De Luca
- CHRU de Tours, Centre Spécialisé de l'Obésité, Tours, France.,Inserm U1069 Université de Tours, Tours, France
| | - Samuele Cortese
- Academic Unit of Psychology, Center for Innovation in Mental Health, University of Southampton, Southampton, United Kingdom.,Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Solent NHS Trust, Southampton, United Kingdom.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, United States.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Régis Hankard
- CHRU de Tours, Centre Spécialisé de l'Obésité, Tours, France.,Inserm U1069 Université de Tours, Tours, France
| | | | - Nicolas Ballon
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France.,INSERM U1253 Imagerie et Cerveau (iBrain), Tours, France
| | | | - Servane Barrault
- Qualipsy, EE 1901, Université de Tours, Tours, France.,CHRU de Tours, Service d'Addictologie Universitaire, Centre de Soins d'Accompagnement et de Prévention en Addictologie d'Indre-et-Loire (CSAPA-37), Tours, France.,Laboratoire de Psychopathologie et Processus de Santé, Université Paris Descartes, Paris, France
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Gökçe Kütük S, Taşdelen Y, Topuz MF, Bilece ZT, Düzenli U, Bora F. The relationship between alexithymia and clinical features in rhinoplasty patients. J Plast Reconstr Aesthet Surg 2021; 75:1729-1734. [PMID: 34969627 DOI: 10.1016/j.bjps.2021.11.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study aimed to investigate the incidence of alexithymia in rhinoplasty patients before and after surgery, and to increase the value of alexithymia analysis. The study also aimed to evaluate self-esteem and rhinoplasty outcome scores together. MATERIAL AND METHODS Patients who had undergone rhinoplasty were enrolled in the study, and they were grouped according to gender, marital status, working status, indication (functional or aesthetic), and type of surgery (primary or revision). Toronto Alexithymia Scale-20 (TAS-20), Rosenberg Self-Esteem Scale (RSES), Rhinoplasty Outcome Evaluation (ROE), and Nasal Obstruction Symptom Evaluation (NOSE) surveys were used to assess their relationship with alexithymia. RESULTS We observed significantly higher alexithymia and lower self-esteem scores in females, widows, those with aesthetic indication, those who required revision surgery, and those who had never worked, and a significant correlation was observed except for marital status (p<0.05). After the surgery, significant improvement was found in TAS-20 and RSES according to preoperative scores (p<0.05). There was a significant inverse correlation between TAS-20 and ROE scores, while a positive correlation was observed between RSES and ROE scores (p<0.05). CONCLUSION This is the first study to investigate alexithymia changes in rhinoplasty candidates. TAS-20 can be considered as a useful survey to assess psychological distress in rhinoplasty candidates.
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Affiliation(s)
- Sinem Gökçe Kütük
- Aydın State Hospital, Department of Otorhinolaryngology, Aydın, Turkey.
| | - Yasin Taşdelen
- Aydın State Hospital, Department of Psychiatry, Aydın, Turkey
| | - Muhammed Fatih Topuz
- Kütahya Medical Sciences University, Department of Otorhinolaryngology, Aydın, Turkey
| | | | - Ufuk Düzenli
- Medipol University, Faculty of Medicine, Department of Otorhinolaryngology, İstanbul, Turkey
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Measuring Knowledge, Attitudes, and Barriers to Medication Adherence in Potential Bariatric Surgery Patients. Obes Surg 2021; 31:4045-4054. [PMID: 34212345 PMCID: PMC8397664 DOI: 10.1007/s11695-021-05485-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/09/2021] [Accepted: 05/14/2021] [Indexed: 11/04/2022]
Abstract
Background Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery. Methods The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations. Results Attitude to adherence was associated with alexithymia (β = ˗2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = −2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale. Conclusion We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done. Graphical Abstract ![]()
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Preoperative psychological characteristics affecting mid-term outcome after bariatric surgery: a follow-up study. Eat Weight Disord 2021; 26:585-590. [PMID: 32207099 DOI: 10.1007/s40519-020-00892-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the relationship between preoperative psychological factors and percentage of total weight loss (%TWL) after laparoscopic Roux-en-Y gastric bypass (LRYGB) to identify possible psychological therapy targets to improve the outcome of bariatric surgery. METHODS Seventy-six patients completed the Hamilton's Anxiety and Depression Scales (HAM-A, HAM-D) and Toronto Alexithymia Scale (TAS-20) the day before surgery (T0). The pre-operative body weight and the %TWL at 3 (T1), 6 (T2), and 24-30 (T3) months were collected. RESULTS At T3, depressed and alexithymic patients showed a lower %TWL compared to non-depressed patients (p = 0.03) and to non-alexithymic patients (p = 0.02), respectively. Finally, patients who had at least one of the three analyzed psychological factors showed less weight loss, at T2 (p = 0.02) and T3 (p = 0.0004). CONCLUSIONS Psychological factors may also affect long-term outcome of bariatric surgery. This study shows an association between alexithymia/depression pre-operative levels and the weight loss at 30 months'follow-up after bariatric surgery. LEVEL OF EVIDENCE Level III, longitudinal cohort study.
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8
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Favieri F, Marini A, Casagrande M. Emotional Regulation and Overeating Behaviors in Children and Adolescents: A Systematic Review. Behav Sci (Basel) 2021; 11:11. [PMID: 33477932 PMCID: PMC7833366 DOI: 10.3390/bs11010011] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
The worldwide prevalence of obesity has dramatically increased, mostly in children and adolescents. The Emotional Eating theoretical model has proposed that the failure in emotional regulation could represent a risk factor for establishing maladaptive overeating behavior that represents an inadequate response to negative emotions and allows increasing body-weight. This systematic review investigates the relationship between overeating and both emotional regulation and emotional intelligence in childhood and adolescence, considering both cross-sectional and longitudinal studies. Moreover, another goal of the review is evaluating whether emotional regulation and emotional intelligence can cause overeating behaviors. The systematic search was conducted according to the PRISMA-statement in the databases Medline, PsychArtcles, PsychInfo, PubMed, Scopus, and Web of Sciences, and allows 484 records to be extracted. Twenty-six studies were selected according to inclusion (e.g., studies focused on children and adolescents without clinical conditions; groups of participants overweight or with obesity) and exclusion (e.g., studies that adopted qualitative assessment or cognitive-affective tasks to measure emotional variables; reviews, commentary, or brief reports) criteria detailed in the methods. Cross-sectional studies showed a negative association between emotional regulation and overeating behavior that was confirmed by longitudinal studies. These findings highlighted the role of maladaptive emotion regulation on overeating and being overweight. The relationship between these constructs in children and adolescents was consistent. The results indicated the complexity of this association, which would be influenced by many physiological, psychological, and social factors. These findings underline the need for further studies focused on emotion regulation in the development of overeating. They should analyze the mediation role of other variables (e.g., attachment style, peer pressure) and identify interventions to prevent and reduce worldwide overweight prevalence.
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Affiliation(s)
- Francesca Favieri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Andrea Marini
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Maria Casagrande
- Department of Dynamic, Clinical and Health Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
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Çalışır S, Çalışır A, Arslan M, İnanlı İ, Çalışkan AM, Eren İ. Assessment of depressive symptoms, self-esteem, and eating psychopathology after laparoscopic sleeve gastrectomy: 1-year follow-up and comparison with healthy controls. Eat Weight Disord 2020; 25:1515-1523. [PMID: 31576497 DOI: 10.1007/s40519-019-00785-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 09/21/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of this study was to assess depressive symptoms, self-esteem, and eating psychopathology in bariatric surgery patients at the preoperative period (t0) and at the 6-month (t1) and 12-month (t2) follow-ups after laparoscopic sleeve gastrectomy (LSG). A second aim was to investigate associations between these variables and weight loss. METHOD The study participants were 48 bariatric surgery candidates and 50 non-obese controls. Both groups underwent assessment with the Sociodemographic Data Form, Hamilton Depression Rating Scale (HDRS), Eating Disorder Examination Questionnaire (EDE-Q), and Rosenberg Self-esteem Scale (RSES). These assessments were repeated for the patient group at t1 and t2. RESULTS The HDRS, RSES, and EDE-Q scores were higher in the patients before LSG (t0) than in the control group. A significant progressive improvement was identified in the patient HDRS and RSES scores as well as EDE-Q weight and shape subscale scores at t1 and t2. However, the patient EDE-Q total and dietary restraint scores improved at t1 then stabilized. The patient EDE-Q eating concern subscale improved at t1, but then worsened. The patient HDRS scores at t2 were similar to the control group, but the EDE-Q and RSES scores were still higher than the control scores at t2. Regression analyses revealed no association between the preoperative scores and percent changes in postoperative scores for any scale and patient weight loss at t2. CONCLUSION Depressive symptoms, self-esteem, and eating psychopathology showed an improving trend in patients after LSG. However, some aspects of eating psychopathology worsened despite an initial improvement. LEVEL OF EVIDENCE III, prospective cohort and case-control study.
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Affiliation(s)
- Saliha Çalışır
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Akın Çalışır
- Department of General Surgery, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Mehmet Arslan
- Department of Psychiatry, Babaeski State Hospital, 39200, Kırklareli, Turkey.
| | - İkbal İnanlı
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - Ali Metehan Çalışkan
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
| | - İbrahim Eren
- Department of Psychiatry, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey
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Bisset CN, Dames N, Oliphant R, Alasadi A, Anderson D, Parson S, Cleland J, Moug SJ. Exploring shared surgical decision-making from the patient's perspective: is the personality of the surgeon important? Colorectal Dis 2020; 22:2214-2221. [PMID: 32628311 DOI: 10.1111/codi.15237] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/16/2020] [Indexed: 02/08/2023]
Abstract
AIM The aim was to determine the importance of a colorectal surgeon's personality to patients and its influence on their decision-making. METHODS We present a two-part mixed methods study using the Guidance for Reporting Involvement of Patients and the Public (GRIPP-2) long form. Part 1 was an online survey (25 questions) and Part 2 a face-to-face patient and public involvement exercise. Part 1 included patient demographics, details of surgery, overall patient satisfaction (net promoter score) and patient views on surgeon personality (Gosling 10 Item Personality Index). The thematic analysis of free-text responses generated four themes that were taken forward to Part 2. These themes were used to structure focus group discussions on surgeon-patient interactions. RESULTS Part 1 yielded 296 responses: 72% women, 75.3% UK-based and 55.1% aged 40-59 years. Inflammatory bowel disease (45.3%) and cancer (40.2%) were the main indications. 84.1% of respondents reported satisfaction with their surgical experience (net promoter score). Four key themes were generated from Part 1 and validated in Part 2: (i) surgeon personality stereotypes (media differed from patients' perspective); (ii) favourable and unfavourable surgical personality traits (openness, conscientiousness, emotional stability preferred over risk-taking and narcissism); (iii) patient-surgeon interaction (mutual respect and rapport valued); (iv) impact of surgeon personality on decision-making (majority unaware of second opinion option; management of postoperative complications). CONCLUSION Patients believe surgeon personality influences shared decision-making. Low levels of emotional stability and conscientiousness are perceived by patients to increase the likelihood of postoperative adverse events. Further work is required to explore the potential influence of surgeon personality on shared decision-making and postoperative outcomes.
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Affiliation(s)
- C N Bisset
- Department of General Surgery, Royal Alexandra Hospital, Paisley, UK.,University of Aberdeen, Aberdeen, UK
| | - N Dames
- ACPGBI Patient Liaison Group Member, Glasgow, UK
| | - R Oliphant
- University of Aberdeen, Aberdeen, UK.,Department of Colorectal Surgery, Raigmore Hospital, Inverness, UK
| | - A Alasadi
- Department of General Surgery, Royal Alexandra Hospital, Paisley, UK
| | - D Anderson
- Department of General Surgery, Royal Alexandra Hospital, Paisley, UK
| | - S Parson
- Suttie Centre, University of Aberdeen, Aberdeen, UK
| | - J Cleland
- Medical Education Research and Scholarship Unit (MERSU), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore City, Singapore
| | - S J Moug
- Department of General Surgery, Royal Alexandra Hospital, Paisley, UK.,University of Glasgow, Glasgow, UK
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Casagrande M, Boncompagni I, Forte G, Guarino A, Favieri F. Emotion and overeating behavior: effects of alexithymia and emotional regulation on overweight and obesity. Eat Weight Disord 2020; 25:1333-1345. [PMID: 31473988 DOI: 10.1007/s40519-019-00767-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Obesity and overweight are significant risk factors for many serious diseases. Several studies have investigated the relationship between emotional regulation and overweight or obesity in people with eating disorders. Although a few studies have explored alexithymia in individuals with severe obesity without eating disorders, no attention has been paid to individuals with overweight and preclinical form of obesity. This study aims to assess whether overweight and obesity are related to emotional dysregulation and alexithymia. METHODS The study involved 111 undergraduate students who had not been diagnosed with an eating disorder. The sample was divided into two groups according to their body mass index (BMI): normal weight (N = 55) and overweight (N = 56). All of them completed the Toronto Alexithymia Scale (TAS-20), the Emotional Regulation Questionnaire (ERQ), and the Eating Disorder Inventory-2 (EDI-2). RESULTS Results showed higher levels of alexithymia, and specifically higher difficulty in identifying feelings and an externally oriented thought, in participants with overweight. Multiple correlation analysis highlighted the positive relations between some EDI-2 subscales and both alexithymia and emotional regulation scores. Linear regressions revealed a significant relationship between body BMI and both alexithymia and emotional regulation strategies. CONCLUSIONS The condition of overweight/obesity seems to be associated with higher emotional dysregulation compared to normal weight condition. It is essential to study this relationship because it could represent a risk factor for the worsening of problems related to overeating and excessive body weight. These findings suggest that an integrated approach aimed at considering the promotion of emotional regulation could contribute to the effectiveness of a program designed to reduce overweight and obesity. LEVEL OF EVIDENCE Level III: case-control analytic study.
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Affiliation(s)
- Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma "Sapienza", Via degli Apuli, 1, 00185, Rome, Italy.
| | - Ilaria Boncompagni
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| | - Angela Guarino
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
| | - Francesca Favieri
- Dipartimento di Psicologia, Università di Roma "Sapienza", Via dei Marsi, 78, 00185, Rome, Italy
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Berkovskaya MA, Tarasenko AA, Fadeev VV, Gurova OY. [Alexithymia and its relation with eating disorders and obesity]. ACTA ACUST UNITED AC 2020; 66:42-48. [PMID: 33351347 DOI: 10.14341/probl12416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/26/2020] [Accepted: 06/09/2020] [Indexed: 11/06/2022]
Abstract
This manuscript provides a review of current literature on the relationship between overweight and alexithymia as a psychological factor associated with obesity, as well as the role of alexithymia in the development of various abnormalities and eating disorders (ED). Obesity is a multifactorial disease, and lifestyle characteristics are the most important pathogenetic links on its development, as well as a complex of genetic, epigenetic, biological and psychological factors that cause accumulation of excessive fat and prevent effective reduction and retention of body weight. One possible reason for the increased prevalence of obesity in adults is poor emotional management, which can affect healthy eating behavior and lifestyle. It was found that overweight and obese people have a high prevalence of alexithymia, and also the study shows its prognostic role in the development of ED. Alexithymia is a factor that not only predisposes to weight gain, but is also a significant predictor of inefficiency and premature termination of programs for the treatment of obesity and ED. Timely diagnosis and correction of alexithymic syndrome can help in developing the effective treatment strategies for obese patients.
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Affiliation(s)
| | - Anna A Tarasenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - Valentin V Fadeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - Olesya Yu Gurova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Galli F, Cavicchioli M, Vegni E, Panizzo V, Giovanelli A, Pontiroli AE, Micheletto G. Ten Years After Bariatric Surgery: Bad Quality of Life Promotes the Need of Psychological Interventions. Front Psychol 2018; 9:2282. [PMID: 30524346 PMCID: PMC6262042 DOI: 10.3389/fpsyg.2018.02282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 11/02/2018] [Indexed: 01/01/2023] Open
Abstract
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 (χ2 = 18.41; p < 0.001) and hypertension (χ2 = 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.
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Affiliation(s)
- Federica Galli
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Marco Cavicchioli
- Department of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Valerio Panizzo
- U.O. Chirurgia Generale, Istituto Nazionale per la Chirurgia dell’Obesità, Istituto Clinico Sant’Ambrogio, Milan, Italy
| | - Alessandro Giovanelli
- U.O. Chirurgia Bariatrica, Istituto Nazionale per la Chirurgia dell’Obesità, Istituto Clinico Sant’Ambrogio, Milan, Italy
| | | | - Giancarlo Micheletto
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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