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Bartholomay EM, Cox S, Tabone L, Szoka N, Abunnaja S, Aylward L. The role of anxiety and depression in understanding the relationship between coping and weight loss 24 months after bariatric surgery. Surg Obes Relat Dis 2024; 20:304-314. [PMID: 38001014 DOI: 10.1016/j.soard.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The relationship between coping (i.e., how a person deals with stress) and weight loss after bariatric surgery is relatively inconsistent. Anxiety and depression may contribute to the lack of consistent findings in this area. It is possible that coping, including interpersonal, intrapersonal, and maladaptive coping, predicts weight loss among individuals with higher levels of anxiety or depression but not among those with lower levels of anxiety and depression. OBJECTIVE The aim of this study was to examine the moderating role of anxiety and depression on the association between coping and weight loss in patients 24 months after bariatric surgery. SETTING University Hospital, West Virginia, U.S.A. METHODS Participants included 841 patients who underwent bariatric surgery, 396 of whom had 24-month weight loss data (mean age, 43.21 yr [SD, ±11.40 yr]). We ran 3 moderation models to test whether the relationship between various coping styles and postoperative weight loss was moderated by anxiety and depression symptoms. RESULTS There was a statistically significant interaction between anxiety and depression on the association between interpersonal coping and percent excess weight loss (%EWL). Anxiety and depression also moderated the relationship between maladaptive coping and %EWL. Anxiety and depression did not moderate the association between intrapersonal coping and %EWL, but intrapersonal coping positively predicted %EWL at 24 months after bariatric surgery. CONCLUSIONS Maladaptive coping predicted less weight loss for patients with high levels of anxiety and/or depression. Interpersonal coping predicted more weight loss for patients with low levels of anxiety and/or depression. Clinicians should take patient levels of anxiety and depression into account when making recommendations to promote weight loss among patients pursuing bariatric surgery.
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Affiliation(s)
- Emily M Bartholomay
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia.
| | - Stephanie Cox
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Lawrence Tabone
- Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Nova Szoka
- Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Salim Abunnaja
- Department of Surgery, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Laura Aylward
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, West Virginia
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Franco L, Jones-Pauley M, Tamimi O, Neshatian L, Nguyen D, Graviss E, Quigley EM, Victor D. Irritable Bowel Syndrome Symptoms in Nonalcoholic Fatty Liver Disease Patients Are an Indicator of Depression and Anxiety. J Clin Gastroenterol 2023; 57:1016-1023. [PMID: 36226999 DOI: 10.1097/mcg.0000000000001770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/31/2022] [Indexed: 12/10/2022]
Abstract
GOALS Determine factors associated with Irritable bowel syndrome (IBS) in nonalcoholic fatty liver disease (NAFLD) patients. BACKGROUND IBS affects 10% to 15% of the adult population worldwide and is linked to anxiety and depression. The impact of IBS-type symptoms in NAFLD patients is not well described. STUDY A cross-sectional study of patients in the hepatology clinic at Houston Methodist Hospital was performed based on a respondent postal survey. IBS was defined by the Rome IV questionnaire, anxiety and depression were assessed with the Hospital Anxiety Depression scale. Patients with inflammatory bowel disease, colorectal carcinoma, or small bowel tumors were excluded. Patients were divided based on Rome IV diagnostic criteria for IBS and Hospital Anxiety Depression scale. RESULTS 130 patients were included in the analysis, 38 satisfied Rome IV criteria for IBS (IBS group) versus 92 who did not (non-IBS group). Depression was more prevalent in the IBS group (18.4% vs 5.4%, P =0.01). Anxiety was also greater in the IBS group (31.6% vs 9.8%, P =0.002). Female sex, depression, and body mass index (BMI)>30 were independent predictors of IBS in NAFLD in 4 multiple logistic regression models. In newly diagnosed IBS patients, gamma-glutamyl transferase levels were lower (67.5 vs 28, P =0.04). Current abdominal pain was higher than 100% versus 81.3% ( P =0.045), as was pain associated with the change in stool frequency (96.3% vs 50%; P <0.001). CONCLUSION Our study highlights the increased rate of IBS symptoms, depression, and anxiety in patients with NAFLD. Clinicians should be alert when IBS symptoms are reported by a NAFLD patient and be aware of the impact of these comorbidities on quality of life and response to therapy.
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Affiliation(s)
- Lissa Franco
- Gastroenterology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Omar Tamimi
- Department of Medicine, Houston Methodist Hospital
| | - Leila Neshatian
- Division of Gastroenterology/Hepatology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA
| | - Duc Nguyen
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Research Institute, Houston, TX
| | - Edward Graviss
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Research Institute, Houston, TX
| | - Eamonn Mm Quigley
- Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology
- Department of Medicine, Houston Methodist Hospital
| | - David Victor
- Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology
- Sherrie and Alan Conover Center for Liver Disease and Transplantation
- Department of Medicine, Houston Methodist Hospital
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Bartholomay EM, Cox S, Tabone L, Szoka N, Abunnaja S, Aylward L. Intrapersonal coping predicts greater weight loss 24 months after bariatric surgery. Obes Surg 2023; 33:3447-3453. [PMID: 37770773 DOI: 10.1007/s11695-023-06826-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/17/2023] [Accepted: 09/15/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE Coping is related to numerous health outcomes, including weight loss. However, the relationship between coping and weight loss after bariatric surgery remains unclear. OBJECTIVES The first objective of this study was to examine cross-sectional relationships between coping, anxiety, and depression. The second objective was to determine whether baseline anxiety and depression predicted weight loss 24 months after bariatric surgery. The final objective was to identify which aspects of coping are related to weight loss 24 months after bariatric surgery. MATERIALS AND METHODS Participants included 1203 adults who completed a pre-surgical bariatric evaluation, including 841 patients who underwent bariatric surgery, 396 of whom had 24-month weight data. Psychological variables were collected during a pre-surgical psychological evaluation. Weight-related variables were obtained through patients' electronic medical records 24 months after surgery. RESULTS Baseline intrapersonal coping (e.g., problem-solving, acceptance) predicted both weight loss variables at 24 months after surgery. However, baseline interpersonal and maladaptive coping were not related to weight loss. Baseline anxiety and depression similarly did not predict weight loss after surgery. CONCLUSION Use of intrapersonal coping strategies at baseline predicted weight loss 24 months after bariatric surgery. Clinicians should assess and bolster these self-reliant coping strategies prior to surgery to improve patient outcomes.
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Affiliation(s)
- Emily M Bartholomay
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV, 26505, USA.
| | - Stephanie Cox
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV, 26505, USA
| | - Lawrence Tabone
- Department of Surgery, West Virginia University School of Medicine, 64 Medical Center Dr, Morgantown, WV, 26505, USA
| | - Nova Szoka
- Department of Surgery, West Virginia University School of Medicine, 64 Medical Center Dr, Morgantown, WV, 26505, USA
| | - Salim Abunnaja
- Department of Surgery, West Virginia University School of Medicine, 64 Medical Center Dr, Morgantown, WV, 26505, USA
| | - Laura Aylward
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, 930 Chestnut Ridge Road, Morgantown, WV, 26505, USA
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Erden Aki ŞÖ, Yıldız Mİ, Kamış GZ, Aytulun A, Karakaya J, Işıklı S. Relationship of depression, impulsivity, distress intolerance and coping styles with maladaptive eating patterns in bariatric candidates. Eat Weight Disord 2022; 27:3351-3366. [PMID: 35999437 DOI: 10.1007/s40519-022-01465-9] [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: 04/25/2022] [Accepted: 07/27/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The study aimed to investigate the problematic eating patterns and understand their relationship to psychological constructs, including stress intolerance, coping mechanisms and impulsivity, and psychiatric symptoms among bariatric surgery candidates. METHODS The bariatric candidates were evaluated by psychiatric interview and standard scales assessing maladaptive eating behaviors (Eating Attitudes Test (EAT), Bulimia Investigatory Test-Edinburgh (BITE), Dutch Eating Behavior Questionnaire (DEBQ)), depression (Beck Depression Inventory (BDI)), psychiatric symptoms (Brief Symptom Inventory (BSI)), and psychological constructs (Distress Intolerance Index (DSI), Coping Styles Scale (CSS), UPPS Impulsive Behavior Scale(UPPS)). RESULTS More than half (57.8%) had maladaptive eating behaviors, and 23.6% had binge-eating behavior. Depression and anxiety predicted EAT, BITE, and DEBQ emotional and external eating sub-scale scores; distress intolerance, helpless coping style, and impulsivity predicted maladaptive eating behaviors in bariatric candidates. CONCLUSION Maladaptive eating patterns play an essential role in the failure to lose weight and regain weight and are predicted by depression, anxiety, and psychological constructs in this study. Evaluation of pathological trait characteristics besides discrete psychiatric syndromes should be recommended in the pre-operation process to plan relevant interventions in the long-term management of weight. LEVEL OF EVIDENCE Level III, evidence obtained from well-designed cohort analytic studies.
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Affiliation(s)
| | - M İrem Yıldız
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - G Zuhal Kamış
- Health Ministry of Turkish Republic Ankara City Hospital, Ankara, Turkey
| | - Aslı Aytulun
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sedat Işıklı
- Department of Psychology, Hacettepe University Faculty of Letters, Ankara, Turkey
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Bozdogan Yesilot S, Yeşilkuş R. Coping and resilience levels of bariatric surgery candidates and affecting factors. Perspect Psychiatr Care 2022; 58:2064-2071. [PMID: 35060134 DOI: 10.1111/ppc.13032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 12/26/2021] [Accepted: 01/11/2022] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study aimed to evaluate coping and resilience levels and affecting factors in candidates for bariatric surgery. DESIGN AND METHODS This was a descriptive study. Data were collected with Personal Information Form, Connor-Davidson Resilience Scale, and Ways of Coping Inventory. FINDINGS This study was completed with 138 bariatric surgery candidates with a mean age of 35.70 ± 10.76. Candidates used problem-focused coping, and their resilience level was moderate. PRACTICE IMPLICATIONS Psychiatric nurses can develop training and counseling programs for the bariatric surgery candidates to enhance problem-focused coping and psychological resilience. These programs can apply routinely throughout the preoperative period and the postoperative period.
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Affiliation(s)
| | - Remziye Yeşilkuş
- Cukurova Goverment Hospital, General Surgery Intensive Care Unit, Adana, Turkey
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Tindle R, Hemi A, Moustafa AA. Social support, psychological flexibility and coping mediate the association between COVID-19 related stress exposure and psychological distress. Sci Rep 2022; 12:8688. [PMID: 35606392 PMCID: PMC9126245 DOI: 10.1038/s41598-022-12262-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/26/2022] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic has contributed to an increase in psychological distress. However, protective factors such as social support, psychological flexibility, and coping mechanisms can help individuals cope with the effects of psychological distress. This study aimed to test a recent hypothesis suggesting that psychological flexibility is not necessarily a coping strategy but a mechanism that can influence the coping strategies an individual employs during stressful events. We tested a mediation model that COVID-19 concerns would contribute to higher levels of perceived social support, which would directly increase psychological flexibility, and finally test if the effect of psychological flexibility on distress was mediated by approach and avoidant coping strategies. The results show that social support facilitates higher levels of psychological flexibility. Further, that psychological flexibility indirectly reduces psychological distress by reducing avoidant coping and increasing approach coping strategies. Within the context of COVID-19, we have shown the importance of social support and psychological flexibility for reducing distress. We have provided further evidence that psychological flexibility might not be a coping mechanism but a strategy that leads individuals to engage in more approach coping strategies and fewer avoidant coping strategies.
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Affiliation(s)
- Richard Tindle
- School of Health and Behavioural Sciences, Discipline of Psychology, University of the Sunshine Coast, Sunshine Coast, QLD, Australia.
| | - Alla Hemi
- School of Education, Bar Ilan University, Ramat Gan, Israel
| | - Ahmed A Moustafa
- Faculty of Society and Design, Bond University, Gold Coast, QLD, Australia.,The Faculty of Health Sciences, Department of Human Anatomy and Physiology, School of Psychology, University of Johannesburg, Johannesburg, South Africa
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Gordon EL, Terrill AL, Smith TW, Ibele AR, Martinez P, McGarrity LA. Overvaluation of Shape and Weight (Not BMI) Associated with Depressive Symptoms and Binge Eating Symptoms Pre- and Post-bariatric Surgery. Obes Surg 2022; 32:2272-2279. [DOI: 10.1007/s11695-022-06062-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022]
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Cavicchioli M, Kraslavski A, Movalli M, Maffei C, Ogliari A. The investigation of mechanisms underlying addictive behaviors: a case-control study. J Addict Dis 2021; 40:306-325. [PMID: 34751104 DOI: 10.1080/10550887.2021.1989250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: The contradictory nature of behavioral addictions has sustained a nondefinitive debate regarding their construct validity. Objective(s): The current study aims at exploring mechanisms underlying two distinct classes of behaviors-behavioral addictions characterized by core alterations in reward processing systems (ARPS) and behaviors with a main function of maladaptive coping. Methods: This case-control study included 99 treatment-seeking individuals with a primary diagnosis of alcohol use disorder (male: N = 68; female: N = 31) and 74 healthy control (HC) subjects (male: N = 38; female: N = 36). The severity of maladaptive behaviors was measured through the Shorter PROMIS Questionnaire (SPQ). Latent mechanisms were assessed by the Disinhibition Domain of the Personality Inventory for DSM-5 (PID-5-DI) and the Acceptance and Action Questionnaire-II (AAQ-II). Results: The clinical group showed higher severity of behavioral addictions than HC. This difference was not replicated for the other class of maladaptive behaviors, except for compulsive buying. Ordinal regression analysis showed that the clinical group significantly predicted SPQ scores reflecting ARPS, SPQ shopping and starving subscales. This was not replicated for the overall SPQ score capturing maladaptive coping and binge eating behaviors. Controlling for PID-5-DI and AAQ-II scores, which were significantly associated to SPQ subscales, effects of the aforementioned clinical group were not significant. Conclusions: The study highlighted distinct and common mechanisms underlying different classes of maladaptive behaviors. Results supported future neuroscience research for clarifying the role of ARPS in compulsive sex and buying in order to consider them as addictive disorders.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Alexandra Kraslavski
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
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Anxiety and Depression Affect Early Postoperative Pain Dimensions after Bariatric Surgery. J Clin Med 2020; 10:jcm10010053. [PMID: 33375765 PMCID: PMC7801948 DOI: 10.3390/jcm10010053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
Uncontrolled postoperative pain and prolonged immobilization after bariatric surgery have been associated with increased postoperative complications and prolonged hospitalization. The aim of our study was to evaluate the postoperative pain that follows bariatric surgery and identify any psychological factors that may affect the early postoperative perception of pain. The study included 100 patients with obesity (women, n = 61; age 37.4 ± 9.9 years, mean ± standard deviation; Body Mass Index (BMI) 47.6 ± 6.5 kg/m2) who underwent bariatric surgery. Preoperative anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale (HADS), and the quantitative and qualitative dimension of early postoperative pain were evaluated by the McGill Pain Questionnaire Short Form (MPQ-SF). Furthermore, the postoperative analgesia protocol was recorded for each patient. Pain declined gradually during the first 24 h postoperative. Although preoperative anxiety had no correlation with the overall pain of postoperative Day 0, patients with a higher level of preoperative anxiety had significantly more intense and more unpleasant pain at 1 h post operation. In addition, depression influences both the intensity and unpleasantness of pain at different time points (1 h, 4 h and 24 h postoperative). Preoperative pain correlated with educational level, but not with age, BMI, gender, marital status, smoking and surgery type. In conclusion, preoperative anxiety and depression influence the early postoperative pain after bariatric surgery, and their preoperative identification is of major importance to enhance the implementation of fast-track postoperative protocols to prevent complications and prolonged hospitalization.
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Zheng Z, Han W, Li Y, Wang D, Gu S, Wang F. The Mediating Effect of Coping Style in the Relationship Between Depression and Disordered Eating Among Chinese Female Undergraduates. Front Psychol 2020; 10:3011. [PMID: 32038388 PMCID: PMC6985573 DOI: 10.3389/fpsyg.2019.03011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022] Open
Abstract
The aim of the current study was to explore the relationship between depression and disordered eating in female undergraduates and the mediating role of coping style between depression and disordered eating. Self-report questionnaires assessing coping style, disordered eating, and depression were completed in 646 Chinese female undergraduates. The results illustrated that there were obvious differences in disordered eating among the undergraduates with various majors. The disordered eating in female undergraduates majoring in art was more serious than those in other majors. Depression and coping style were effective indicators to predict disordered eating. Moreover, depression could not only directly predict disordered eating, but also predict disordered eating through the mediating effect of coping style. These findings indicate that depression and negative coping style are associated with disordered eating. Coping style could mediate the effect of depression on disordered eating, as these may be an important target for early intervention programs for eating disorder (ED).
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Affiliation(s)
- Zheng Zheng
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenyue Han
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yawen Li
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Dongyan Wang
- School of Medicine and Holistic Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Simeng Gu
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Fushun Wang
- Institute of Brain and Psychological Science, Sichuan Normal University, Chengdu, China
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