ویژگی های روانشناختی بیماران ایرانی تحت عمل جراحی چاقی در دوران همه گیری و قرنطینه کووید-19

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد روانشناسی بالینی، دانشکده روانشناسی و علوم تربیتی، دانشگاه آزاد اسلامی واحد تهران جنوب، تهران، ایران

2 کارشناسی ارشد روانشناسی بالینی کودک و نوجوان، گروه روانشناسی بالینی، دانشکده علوم رفتاری، دانشگاه علوم بهزیستی و توانبخشی، تهران،

چکیده

مقدمه: بیماری های فراگیر به عنوان شناخته شده ترین عوامل در ایجاد پریشانی روانی هستند. مطالعۀ حاضر، ویژگی های روانشناختی همه گیری کووید-19 را در بیماران ایرانی شرکت کننده در برنامۀ جراحی چاقی را بررسی می‌کند.
روش: در دوران قرنطینه، بیماران از میان افرادی که متقاضی جراحی‌چاقی بودند و یا در مرحلۀ پیگیری بعد از جراحی‌چاقی بودند، انتخاب شدند و از آنها خواسته‌شد تا مقیاس‌های افسردگی-‌اضطراب‌-استرس21 و پرسشنامۀ خود-‌ارزیابی 22 آیتمی را که تاب‌آوری، تغییر در رفتار خوردن و پاسخ‌های هیجانی را می‌سنجد، تکمیل‌کنند.
یافته ها: 59% از 434 نفر شرکت‌کننده، نگران همه‌گیری بودند و 63% نگران سلامتی خود یا بستگانشان بودند. به ترتیب 37% و 56% احساس تنهایی و کسالت داشتند. 66% با افزایش دفعات میان‌وعده مواجه‌شدند و 55% نسبت به قبل، احساس گرسنگی بیشتری می‌کردند و 39% تکانه بیشتری برای غذا‌ خوردن گزارش‌کردند. 49% احساس می‌کردند که نمی‌توانند از یک رژیم‌غذایی توصیه‌شده توسط پزشک پیروی کنند. آنالیز رگرسیون لجستیک، رابطۀ بین تعداد میان‌وعده، گرسنگی، خوردن تکانشی و اضطراب، استرس و یا علائم افسردگی را نشان‌داد.
نتیجه گیری: همه‌گیری منجر به افزایش پریشانی‌روانشناختی در بیماران با سابقۀ جراحی فعلی یا گذشته، کاهش کیفیت‌زندگی و تأثیر بر رعایت رژیم‌غذایی می‌شود. حمایت روانشناختی هدفمند در زمان افزایش استرس برای افراد مستعد (مانند بیماران چاقی قبل و بعد از عمل) ضروری است.

کلیدواژه‌ها


عنوان مقاله [English]

Psychological characteristics of Iranian patients undergoing bariatric surgery during the COVID‑19 pandemic and lockdown

نویسندگان [English]

  • Behnush Nik Khah 1
  • Shadi Agha Ali Tari 1
  • Soudabeh Yekrang Safakar 1
  • Yasaman Rahiminikoo 2
1 Master of Clinical Psychology, Faculty of Psychology and Educational Sciences, Islamic Azad University, South Tehran Branch, Tehran, Iran
2 Master of Child and Adolescent Clinical Psychology, Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
چکیده [English]

Introduction: Pandemics are the most well-known to cause mental distress. This study examines the psychological characteristics of Iranian patients undergoing bariatric surgery during the COVID‑19 pandemic and lockdown.
Method: Patients were consecutively recruited during the quarantine among those waiting for bariatric surgery or attending a post-bariatric follow-up phase and were asked to complete the Depression-Anxiety-Stress Scales-21 and a self-assessment questionnaire of 22 items assessing the resilience, change in eating behavior, and emotional responses referring to the current epidemic.
Results: 59% of the 434 recruited participants reported of being worried about the epidemic, and 63% particularly reported of being worried about their or their relatives’ health. 37% and 56% felt lonelier and more bored, respectively. 66% was hungrier with an increased frequency of snacking (55%) and 39% reported more impulse to eat. Remarkably, 49% felt unable to follow a recommended diet. Logistic regression analysis on post-bariatric patients revealed an association between snacking, hunger, eating impulsivity, and anxiety, stress, and/or depression symptoms.
Conclusion: Epidemics led to incremented psychological distress in patients with a history of current or past obesity, decreased quality of life, and impacting dietary compliance. Targeted psychological support is warranted in times of increased stress for susceptible participants such as pre-and post-bariatric patients.

کلیدواژه‌ها [English]

  • COVID-19
  • Bariatric Surgery
  • Anxiety
  • depression
  • Stress
منابع
1. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology. 2020:200490.
2. Jukic I, Calleja-González J, Cos F, Cuzzolin F, Olmo J, Terrados N, et al. Strategies and solutions for team sports athletes in isolation due to covid-19. Multidisciplinary Digital Publishing Institute; 2020.
3. Del Rio C, Malani PN. COVID-19—new insights on a rapidly changing epidemic. Jama. 2020; 323(14): 1339-40.
4. Müller N. Infectious diseases and mental health. Comorbidity of Mental and Physical Disorders. 2014:99.
5. Sim K, Chan YH, Chong PN, Chua HC, Soon SW. Psychosocial and coping responses within the community health care setting towards a national outbreak of an infectious disease. Journal of psychosomatic research. 2010;68(2):195-202.
6. Tucci V, Moukaddam N, Meadows J, Shah S, Galwankar SC, Kapur GB. The forgotten plague: psychiatric manifestations of ebola, zika, and emerging infectious diseases. Journal of global infectious diseases. 2017;9(4):151.
7. Cheng SK, Wong C, Tsang J, Wong K. Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS). Psychological Medicine. 2004;34(7):1187.
8. Lee AM, Wong JG, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. The Canadian Journal of Psychiatry. 2007;52(4):233-40.
9. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerging infectious diseases. 2004;10(7):1206-12.
10. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health. 2020;17(5):1729.
11. Malik S, Mitchell JE, Engel S, Crosby R, Wonderlich S. Psychopathology in bariatric surgery candidates: a review of studies using structured diagnostic interviews. Compr Psychiatry. 2014;55(2):248-59.
12. Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW. Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2003;158(12):1139-47.
13. Sarwer DB, Allison KC, Wadden TA, Ashare R, Spitzer JC, McCuen-Wurst C, et al. Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery. Surgery for Obesity and Related Diseases. 2019;15(4):650-5.
14. Yanovski SZ. Binge eating disorder and obesity in 2003: could treating an eating disorder have a positive effect on the obesity epidemic? International Journal of Eating Disorders. 2003;34(S1):S117-S20.
15. Herpertz S, Kielmann R, Wolf A, Hebebrand J, Senf W. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obesity research. 2004;12(10):1554-69.
16. Taube-Schiff M, Van Exan J, Tanaka R, Wnuk S, Hawa R, Sockalingam S. Attachment style and emotional eating in bariatric surgery candidates: The mediating role of difficulties in emotion regulation. Eating behaviors. 2015;18:36-40.
17. Nasirzadeh Y, Kantarovich K, Wnuk S, Okrainec A, Cassin SE, Hawa R, et al. Binge eating, loss of control over eating, emotional eating, and night eating after bariatric surgery: results from the Toronto Bari-PSYCH Cohort Study. Obesity surgery. 2018;28(7):2032-9.
18. Azizi F, Rahmani M, Emami H, Mirmiran P, Hajipour R, Madjid M, et al. Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Sozial-und präventivmedizin. 2002;47(6):408-26.
19. Cuthbertson DJ, Alam U, Tahrani A. <? covid19?> COVID-19 and obesity: an opportunity for change. SAGE Publications Sage UK: London, England; 2020.
20. Holman N, Knighton P, Kar P, O’Keefe J, Curley M, Weaver A, et al. Type 1 and type 2 diabetes and COVID-19 related mortality in England: a cohort study in people with diabetes. 2020.
21. Bowden Davies KA, Pickles S, Sprung VS, Kemp GJ, Alam U, Moore DR, et al. Reduced physical activity in young and older adults: metabolic and musculoskeletal implications. Therapeutic advances in endocrinology and metabolism. 2019;10:2042018819888824.
22. Davies KAB, Sprung VS, Norman JA, Thompson A, Mitchell KL, Halford JC, et al. Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes. Diabetologia. 2018;61(6):1282-94.
23. Clemmensen C, Petersen MB, Sørensen TI. Will the COVID-19 pandemic worsen the obesity epidemic? Nature Reviews Endocrinology. 2020;16(9):469-70.
24. Björntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obesity reviews. 2001;2(2):73-86.
25. Kim D, Subramanian S, Gortmaker SL, Kawachi I. US state-and county-level social capital in relation to obesity and physical inactivity: a multilevel, multivariable analysis. Social science & medicine. 2006;63(4):1045-59.
26. Higgs S, Ruddock H. Social influences on eating. Handbook of eating and drinking: Interdisciplinary perspectives. 2020:277-91.
27. Peterman JN, Wilde PE, Liang S, Bermudez OI, Silka L, Rogers BL. Relationship between past food deprivation and current dietary practices and weight status among Cambodian refugee women in Lowell, MA. American journal of public health. 2010;100(10):1930-7.
28. Troisi A. Bariatric Psychology and Psychiatry: Springer; 2020.
29. Sahebi A, Asghari MJ, Salari RS. Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Developmental Psychology: Iranian Psychologists. 2005;1(4):36-54.
30. Henry JD, Crawford JR. The 21-item version of the Depression Anxiety Stress Scales (DASS–21): Normative data and psychometric evaluation in a large non-clinical sample. British Journal of Clinical Psychology. 2005;44(22):227-39.
31. Samani S, Jokar B. Examining validity and reliability of brief form depression, anxiety and stress scale. J Soc Sci Hum Shiraz Univ. 2007;26(3):65-77.
32. Jensen MP. Questionnaire validation: a brief guide for readers of the research literature. The Clinical journal of pain. 2003;19(6):345-52.
33. Asghari Moghaddam Ma, Saed F, Dibajnia P, Zangeneh J. A Preliminary Validation Of The Depression, Anxiety And Stress Scales (Dass) In Non-Clinical Sample. Daneshvar Raftar. 2008;15(31 (Special Edition On Psychology 11)):-.
34. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet. 2020.
35. Busetto L, Bettini S, Fabris R, Serra R, Dal Pra’ C, Maffei P, et al. Obesity and COVID‐19: an Italian snapshot. Obesity. 2020.
36. Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clinical Infectious Diseases. 2020.
37. Watanabe M, Caruso D, Tuccinardi D, Risi R, Zerunian M, Polici M, et al. Visceral fat shows the strongest association with the need of intensive care in patients with COVID-19. Metabolism. 2020;111:154319.
38. Watanabe M, Risi R, Tuccinardi D, Baquero CJ, Manfrini S, Gnessi L. Obesity and SARS‐CoV‐2: a population to safeguard. Diabetes/Metabolism Research and Reviews. 2020:e3325.
39. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatric Services. 2004;55(9):1055-7.
40. Blendon RJ, Benson JM, DesRoches CM, Raleigh E, Taylor-Clark K. The public's response to severe acute respiratory syndrome in Toronto and the United States. Clinical infectious diseases. 2004;38(7):925-31.
41. Desclaux A, Badji D, Ndione AG, Sow K. Accepted monitoring or endured quarantine? Ebola contacts' perceptions in Senegal. Social science & medicine. 2017;178:38-45.
42. Reynolds DL, Garay J, Deamond S, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiology & Infection. 2008;136(7):997-1007.
43. Sockalingam S, Leung SE, Cassin SE. The Impact of Coronavirus Disease 2019 on Bariatric Surgery: Redefining Psychosocial Care. Obesity. 2020;28(6):1010-2.
44. Şeniz Ü, Sevi̇nçer GM, Maner AF. Prediction of Weight Regain After Bariatric Surgery by Night Eating, Emotional Eating, Eating Concerns, Depression and Demographic Characteristics. Turk Psikiyatri Dergisi. 2019;30(1):31.
45. Sisto A, Vicinanza F, Campanozzi LL, Ricci G, Tartaglini D, Tambone V. Towards a transversal definition of psychological resilience: A literature review. Medicina. 2019;55(11):745.
46. Farr OM, Tuccinardi D, Upadhyay J, Oussaada SM, Mantzoros CS. Walnut consumption increases activation of the insula to highly desirable food cues: A randomized, double‐blind, placebo‐controlled, cross‐over fMRI study. Diabetes, Obesity and Metabolism. 2018;20(1):173-7.
47. Tuccinardi D, Farr OM, Upadhyay J, Oussaada SM, Klapa MI, Candela M, et al. Mechanisms underlying the cardiometabolic protective effect of walnut consumption in obese people: A cross‐over, randomized, double‐blind, controlled inpatient physiology study. Diabetes, Obesity and Metabolism. 2019;21(9):2086-95.
48. Poddar K, Kolge S, Bezman L, Mullin GE, Cheskin LJ. Nutraceutical supplements for weight loss: a systematic review. Nutrition in Clinical Practice. 2011;26(5):539-52.
49. Watanabe M, Gangitano E, Francomano D, Addessi E, Toscano R, Costantini D, et al. Mangosteen extract shows a potent insulin sensitizing effect in obese female patients: a prospective randomized controlled pilot study. Nutrients. 2018;10(5):586.
50. Basciani S, Camajani E, Contini S, Persichetti A, Risi R, Bertoldi L, et al. Very-Low-Calorie Ketogenic Diets with Whey, Vegetable or Animal Protein in Patients with Obesity: A Randomized Pilot Study. The Journal of Clinical Endocrinology & Metabolism. 2020.
51. Bruci A, Tuccinardi D, Tozzi R, Balena A, Santucci S, Frontani R, et al. Very low-calorie ketogenic diet: a safe and effective tool for weight loss in patients with obesity and mild kidney failure. Nutrients. 2020;12(2):333.
52. Castellana M, Conte E, Cignarelli A, Perrini S, Giustina A, Giovanella L, et al. Efficacy and safety of very low calorie ketogenic diet (VLCKD) in patients with overweight and obesity: A systematic review and meta-analysis. Reviews in Endocrine and Metabolic Disorders. 2020;21(1):5-16.
53. Ricci A, Idzikowski MA, Soares CN, Brietzke E. Exploring the mechanisms of action of the antidepressant effect of the ketogenic diet. Reviews in the Neurosciences. 2020;1(ahead-of-print).
54. Tsilingiris D, Liatis S, Dalamaga M, Kokkinos A. The Fight Against Obesity Escalates: New Drugs on the Horizon and Metabolic Implications. Current obesity reports. 2020.
55. Tuccinardi D, Farr OM, Upadhyay J, Oussaada SM, Mathew H, Paschou SA, et al. Lorcaserin treatment decreases body weight and reduces cardiometabolic risk factors in obese adults: A six‐month, randomized, placebo‐controlled, double‐blind clinical trial. Diabetes, Obesity and Metabolism. 2019;21(6):1487-92.
56. Mariani S, Watanabe M, Lubrano C, Basciani S, Migliaccio S, Gnessi L. Interdisciplinary approach to obesity. Multidisciplinary approach to obesity: Springer; 2015. p. 337-42.