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Biomedical subjects

Patricia H Rosenberger

Publications and source records attributed to Patricia H Rosenberger.

4 recordsLinked to original sources

Correlates of body image dissatisfaction in extremely obese female bariatric surgery candidates.

BACKGROUND: This study investigated correlates of body image dissatisfaction in 131 extremely obese female bariatric surgery candidates. METHODS: Female gastric bypass surgery candidates participating in a comprehensive psychiatric evaluation completed a battery of established self-report measures of body image and psychosocial functioning. Nine predictors of body image dissatisfaction were considered: body mass index (BMI), ethnicity, childhood onset of obesity, childhood teasing about weight, binge eating, depression, self-esteem, shame, and perfectionism. RESULTS: Stepwise multiple regression analysis revealed that the nine variables jointly accounted for 48% of the variance; three variables, depression, self-esteem and perfectionism, made significant independent contributions. CONCLUSION: Our findings highlight the importance of adult psychological functioning (depression, self-esteem and perfectionism) for predicting body image dissatisfaction in extremely obese female bariatric surgery candidates.

Adult↗

Psychiatric disorder comorbidity and association with eating disorders in bariatric surgery patients: A cross-sectional study using structured interview-based diagnosis.

OBJECTIVE: This study examined the prevalence of DSM-IV Axis I psychiatric disorders in severely obese bariatric surgery candidates and explored whether eating disorders were associated with psychiatric comorbidity. METHOD: The Structured Clinical Interview for DSM-IV Axis I Disorders was administered to a study group of 174 consecutively evaluated bariatric surgery candidates. All evaluations were completed between September 2002 and November 2004. RESULTS: Overall, 36.8% of the participants met criteria for at least one lifetime psychiatric disorder, with 24.1% meeting criteria for a current disorder. The most commonly observed lifetime psychiatric diagnoses were affective disorders (22.4%), anxiety disorders (15.5%), and eating disorders (13.8%). Participants with eating disorders were significantly more likely than those without eating disorders to meet criteria for psychiatric disorders overall (66.7% vs. 26.7%) and specifically for anxiety disorders (45.8% vs. 10.7%). CONCLUSIONS: Psychiatric disorders are not uncommon among severely obese patients who present for bariatric surgery. The observed prevalence rates based on structured diagnostic interviews are lower than previously reported based on questionnaire, clinical, and chart review methods but are similar to those reported for nationally representative samples. Among bariatric surgery candidates, the presence of eating disorders is associated with higher rates of other psychiatric disorders. The findings highlight the importance of systematic diagnostic assessment using a structured diagnostic interview for determining the full spectrum of Axis I disorders.

Anastomosis, Roux-en-Y↗

Psychosocial factors and surgical outcomes: an evidence-based literature review.

The influence of psychosocial factors on clinical outcomes after surgery has been investigated in several studies. This review is limited to surgical outcomes studies published between 1990 and 2004 that include (1) psychosocial variables (eg, depression, social support) as predictors of outcome and that focus on (2) clinical outcomes (eg, postoperative pain, functional recovery) using (3) specific multivariate analytic techniques with (4) relevant clinical variables (eg, presurgical health status) included as covariates. Twenty-nine studies met these criteria. Results indicate that psychosocial factors play a significant role in recovery and are predictive of surgical outcome, even after accounting for known clinical factors. Attitudinal and mood factors were strongly predictive; personality factors were least predictive. The results suggest that preoperative consideration of attitudinal and mood factors will assist the surgeon in estimating both the speed and extent of postoperative recovery.

Affect↗

Shared decision making, preoperative expectations, and postoperative reality: differences in physician and patient predictions and ratings of knee surgery outcomes.

PURPOSE: The present study was performed to determine the extent to which physicians and patients rate preoperative and postoperative knee pain and function differently, and to determine whether physicians or patients more accurately predict postoperative knee pain and function. TYPE OF STUDY: Longitudinal, prospective study. METHODS: Ninety-eight patients requiring either anterior cruciate ligament reconstruction surgery or meniscectomy and related surgery were interviewed 1 week before surgery, as well as 3 and 24 weeks postoperatively. Patients and their physicians completed ratings on knee pain and function at each time point. In addition, at their preoperative visit, patients and physicians completed ratings predicting their postoperative pain and functional status. RESULTS: Physicians rated patients as having less pain and greater knee function preoperatively and at 24 weeks postoperatively. Patients had more significant differences between predicted and actual ratings. CONCLUSIONS: Physicians tended to underestimate knee pain and overestimate knee function compared with patients. However, physicians better predicted postoperative knee pain and function ratings than did patients. These findings suggest that physician-patient discussions about preoperative expectations and postoperative reality might be an important part of clinical care. LEVEL OF EVIDENCE: Level II, Prospective Longitudinal Study.

Anterior Cruciate Ligament↗