A high prevalence of psychological trauma on one hand and of psychiatric disorders, such as depression, anxiety, suicide attempts, addictions, and eating disorders on the other hand, has been reported in patients with severe obesity seeking bariatric surgery. Some studies reported an increased prevalence of these psychiatric disorders after bariatric surgery, potentially related to weight regain. In this context, psychological resilience is a concept that brings together internal and external factors of adaptation, and whose clinical use facilitates interdisciplinary collaborative work. This research focuses on the association between resilience and success or failure of bariatric surgery in patients followed in the Specialized Obesity Center (CSO) of the Nancy University Hospital. The hypothesis is that psychological resilience before surgery promotes successful surgical treatment. This retrospective study is based on existing data from patients with severe obesity who have undergone bariatric surgery at the Nancy CSO. The main objective is to study 1) the resilience of patients with severe obesity, candidates for bariatric surgery, at the first assessment (T0), at the end of lifestyle/behavioral modifications program (T1) and at 2 years after bariatric surgery (T2), 2) the relationship between internal and external factors explaining resilience and final weight outcomes. The investigators are expected that non-resilient patients have more psychological vulnerabilities (psychopathology, negative life events, etc.), and have lower weight loss than resilient patients.
The investigators will report the change of resilience during lifestyle/behavioral modifications program and 2 years after bariatric surgical treatment, and the investigators will describe the factors associated with this change: * History of trauma * Psychopathology (eating disorders, depression, anxiety, addiction) * Personality factors * Characteristic of psychotherapy
Study Type
OBSERVATIONAL
Enrollment
200
Centre hospitalo-universitaire régional de Nancy
Vandœuvre-lès-Nancy, France
Resilience (Questionnaire) : Resilience Scale for Adult (RSA)
Min: 33 ; Max: 231; Higher scores mean a better outcome Score of resilience (Resilience Scale for adults) and level of resilience (non-resilient, intermediate, resilient) / number of patients in each category
Time frame: baseline (T0)
Resilience (semi-structured interview) : level of resilience
Categories : Non-resilient, intermediate, resilient Number and % of patients in each category
Time frame: baseline (T0)
Resilience (Questionnaire) : Resilience Scale for Adult (RSA)
Min: 33 ; Max: 231; Higher scores mean a better outcome
Time frame: 10 months (T1)
Resilience (semi-structured interview) : level of resilience
Categories : Non-resilient, intermediate, resilient Number and % of patients in each category
Time frame: 10 months (T1)
Resilience (Questionnaire) : Resilience Scale for Adult (RSA)
Min: 33 ; Max: 231; Higher scores mean a better outcome.
Time frame: 2 years after surgery (T2)
Resilience (semi-structured interview) : level of resilience
Categories : Non-resilient, intermediate, resilient Number and % of patients in each category
Time frame: 2 years after surgery (T2)
Hospital Anxiety and Depression scale (HAD)
Min: 0 ; Max: 42; Higher scores mean a worse outcome.
Time frame: baseline (T0)
Dutch Eating Behaviour Questionnaire (DEBQ)
Min: 33 ; Max: 165 ; Higher scores mean a worse outcome
Time frame: baseline (T0)
Binge eating scale (BES)
Min: 0 ; Max: 48 ; Higher scores mean a worse outcome.
Time frame: baseline (T0)
Mini International Neuropsychiatric Interview (semi-structured interview)
Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders).
Time frame: baseline (T0)
Psychological trauma (semi-structured interview)
Number and % of patients in each category (Sexual, physical, emotional abuse, emotional and physical neglect) Number and % of patients in each category for the first trauma (childhood, adolescence, adulthood)
Time frame: Baseline (T0)
Childhood Trauma Questionnaire (CTQ)
Min: 25 ; Max: 125 ; Higher scores mean a worse outcome
Time frame: baseline (T0)
Toronto Alexithymia Scale (TAS)
Min: 20 ; Max: 100 ; Higher scores mean a worse outcome
Time frame: baseline (T0)
Medical Outcomes Study Short Form (SF-36)
Min: 0 ; Max: 100 ; Higher scores mean a better outcome.
Time frame: baseline (T0)
Definition of patient's psychological profile : clinical interviews
Profile is determined by clinical interviews
Time frame: baseline (T0)
Definition of patient's psychological profile : Rorschach test
Profile is determined by Rorschach test
Time frame: baseline (T0)
Characteristics of psychotherapy : Duration
Duration of psychotherapy (month)
Time frame: baseline (T0)
Characteristics of psychotherapy : Frequency
Frequency of psychotherapy (number of sessions per month)
Time frame: baseline (T0)
Characteristics of psychotherapy: Type of professional
Type of professional (Psychiatrist, Psychologist, Nurse, Other)
Time frame: baseline (T0)
Characteristics of psychotherapy : Investment
Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome.
Time frame: baseline (T0)
Sex
men/women
Time frame: baseline (T0)
Age
years
Time frame: baseline (T0)
Professional situation
Active / Unemployed / Homemaker / Retired / Unable to work
Time frame: baseline (T0)
Family situation
Currently married/cohabiting / Formerly married / Never married
Time frame: baseline (T0)
Weight data
Weight: kg BMI: kg/m²
Time frame: baseline (T0)
Hospital Anxiety and Depression scale (HAD)
Min: 0 ; Max: 42; Higher scores mean a worse outcome
Time frame: 10 months (T1)
Dutch Eating Behaviour Questionnaire (DEBQ)
Min: 33 ; Max: 165 ; Higher scores mean a worse outcome
Time frame: 10 months (T1)
Binge eating scale (BES)
Min: 0 ; Max: 48 ; Higher scores mean a worse outcome
Time frame: 10 months (T1)
Mini International Neuropsychiatric Interview
• Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders).
Time frame: 10 months (T1)
Toronto Alexithymia Scale (TAS)
Min: 20 ; Max: 100 ; Higher scores mean a worse outcome.
Time frame: 10 months (T1)
Medical Outcomes Study Short Form (SF-36)
Min: 0 ; Max: 100 ; Higher scores mean a better outcome.
Time frame: 10 months (T1)
Definition of patient's psychological profile :clinical interviews
Profile is determined by clinical interviews
Time frame: 10 months (T1)
Definition of patient's psychological profile : Rorschach test
Profile is determined by Rorschach test
Time frame: 10 months (T1)
Characteristics of psychotherapy: Duration
Duration of psychotherapy (month)
Time frame: 10 months (T1)
Characteristics of psychotherapy: Frequency
Frequency of psychotherapy (number of sessions per month)
Time frame: 10 months (T1)
Characteristics of psychotherapy: Type of professional
Type of professional (Psychiatrist, Psychologist, Nurse, Other)
Time frame: 10 months (T1)
Characteristics of psychotherapy: Investment
Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome.
Time frame: 10 months (T1)
Professional situation
Active / Unemployed / Homemaker / Retired / Unable to work
Time frame: 10 months (T1)
Family situation
Currently married/cohabiting / Formerly married / Never married
Time frame: 10 months (T1)
Weight data
Weight: kg BMI: kg/m²
Time frame: 10 months (T1)
Hospital Anxiety and Depression scale (HAD)
Min: 0 ; Max: 42; Higher scores mean a worse outcome.
Time frame: 2 years after surgery (T2)
Dutch Eating Behaviour Questionnaire (DEBQ)
Min: 33 ; Max: 165 ; Higher scores mean a worse outcome.
Time frame: 2 years after surgery (T2)
Binge eating scale (BES)
Min: 0 ; Max: 48 ; Higher scores mean a worse outcome.
Time frame: 2 years after surgery (T2)
Mini International Neuropsychiatric Interview
• Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders).
Time frame: 2 years after surgery (T2)
Toronto Alexithymia Scale (TAS)
Min: 20 ; Max: 100 ; Higher scores mean a worse outcome.
Time frame: 2 years after surgery (T2)
Medical Outcomes Study Short Form (SF-36)
Min: 0 ; Max: 100 ; Higher scores mean a better outcome.
Time frame: 2 years after surgery (T2)
Definition of patient's psychological profile : clinical interviews
Profile is determined by clinical interviews
Time frame: 2 years after surgery (T2)
Definition of patient's psychological profile : Rorschach test
Profile is determined by Rorschach test
Time frame: 2 years after surgery (T2)
Characteristics of psychotherapy: Duration
Duration of psychotherapy (month)
Time frame: 2 years after surgery (T2)
Characteristics of psychotherapy: Frequency
Frequency of psychotherapy (number of sessions per month)
Time frame: 2 years after surgery (T2)
Characteristics of psychotherapy: Type of professional
Type of professional (Psychiatrist, Psychologist, Nurse, Other)
Time frame: 2 years after surgery (T2)
Characteristics of psychotherapy: Investment
Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome.
Time frame: 2 years after surgery (T2)
Professional situation
Active / Unemployed / Homemaker / Retired / Unable to work
Time frame: 2 years after surgery (T2)
Family situation
Currently married/cohabiting / Formerly married / Never married
Time frame: 2 years after surgery (T2)
Weight data
Weight: kg BMI: kg/m²
Time frame: 2 years after surgery (T2)
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