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腹部外科手術を希望し,受けている患者の精神的健康状態:メタ解析
Aaron J Dawes1, Melinda Maggard-Gibbons2, Alicia R Maher3
1Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California2Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California3Veterans Affairs/Robert Wood Johnson Clinical Scholars Program, UCLA, Los Angeles, Cali.
JAMA
|January 13, 2016
まとめ
うつ病や過食障害のような 精神疾患は 減量手術の患者でよく見られます 体重減少への影響は不明ですが 手術後のうつ病率は改善しているようです
科学分野:
- 腹部外科
- 肥満
- 精神的健康について
- 精神疾患
背景:
- 重度の肥満の人は 持続的な体重減少と身体的健康の改善のために 腹筋外科手術を求めることがよくあります
- 精神疾患は,この患者集団で頻繁に観察されていますが,その罹患率と手術結果への影響はよく確立されていません.
研究 の 目的:
- 精力外科手術の候補者と受診者の精神疾患の有病率を決定する.
- 術前の精神状態と術後の結果との関連性を評価する.
- 精神疾患の臨床経過に対する 減量手術の影響を評価する.
主な方法:
- 1988年1月から2015年11月まで,PubMed,MEDLINE,PsycINFOで体系的な文献検索が行われました.
- バイアスのリスクに適応したツールを用いて研究の質を評価した.
- 証拠の質はGRADE基準を用いて評価された.
主要な成果:
- このレビューは68の出版物を特定し,59が手術前の精神疾患の流行 (n=65,363) と27が手術後の結果との関連性 (n=50,182) を報告した.
- 最も一般的な症状はうつ病 (19%) と過食障害 (17%).
- 術前の精神状態と術後の体重減少との関連に関する証拠は矛盾していましたが,腹筋外科手術は手術後のうつ病の発生率と重度の低下と一貫して関連していました.
結論:
- 精神疾患,特にうつ病や過食障害は 腹筋外科手術を受ける人の間で一般的です
- 手術前における精神的健康と 手術後の体重減少の関係は 矛盾しています
- 腹腔外科手術は 術後の精神的健康の改善,特にうつ病の減少と ポジティブな関連性を示しています
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