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Yıl:2019; Cilt: 20; Sayı: 6>> Özet
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Anadolu Psikiyatri Dergisi; 2019;20(6):605-612
Morbid obezite hastalarında gece yeme davranışı ve psikiyatrik eş tanı
L Atik, Ö Saraçlı, VÇ Kardeş, MC Mete, N Atasoy
Bülent Ecevit Üniversitesi, Zonguldak
Amaç: Gece yeme sendromu (GYS) ile obezite ilişkisi bir kısır döngüyü andırmaktadır. GYS varlığı obeziteye kaymayı kolaylaştırırken, obez bireylerde GYS daha sık görülmektedir. Literatürde morbid obezitesi olan bireylerde GYS’nin oranı %2-20 arasında bildirilmiştir. Obeziteye ek olarak GYS’nin de olması depresyon puanlarının daha yüksek, benlik saygısının daha düşük olması ile ilişkili bulunmuştur. Bu çalışmada morbid obezite hastalarında GYS yaygınlığı ve ilişkili etkenlerin araştırılması amaçlanmıştır. Yöntem: Bu çalışmada Bülent Ecevit Üniversite Hastanesi Psikiyatri Polikliniği’ne, morbid obezite cerrahisi öncesi psikiyatrik değerlendirme için başvuran 452 hasta değerlendirilmiştir. Psikiyatrik bozukluk varlığı bir psikiyatri uzmanı tarafından yapılan klinik görüşme ile değerlendirildi. Sosyoekonomik ve klinik özellikler, yaş, cinsiyet, eğitim düzeyi, beden kitle indeksi kaydedildi. Beck Depres-yon ve Beck Anksiyete Ölçekleri, Rosenberg Benlik Saygısı Ölçeği ve Gece Yeme Anketini doldurmaları istendi. Bulgular: Dört yüz elli iki morbid obezite hastasının 59’unda (%13) GYS saptandı. GYS saptanan grupta BDÖ, BAÖ ve RBSÖ puanları GYS olmayan gruba göre anlamlı düzeyde daha yüksekti. GYS’li grupta, GYS olmayanlara göre psikiyatrik bozukluk (sırasıyla, %44.1 ve %26.2) ve depresyon (sırasıyla, %25.4 ve %13) oranı anlamlı olarak daha yüksekti. Morbid obezite örnekleminde sigara içmenin GYS görülme riskini 3.05 kat, BDÖ’deki 1 birimlik artışın GYS görülme riskini 1.05 kat artırdığı bulundu. Tartışma: Çalışmamızda morbid obezite hastalarında GYS eş tanı-sının psikiyatrik bozukluk, özellikle depresyon riskini artırdığı, bu hastalarda benlik saygısının daha kötü olduğu saptanmıştır. Sigaranın, GYS varlığı açısından en yüksek yordayıcı faktör bulunması başka çalışmalarda da göste-rilmiş olan bir bulgudur. Bariyatrik cerrahi sonrası depresyon, GYS ve yeme paterni ile ilgili değişikliklerin tarandığı uzun süreli izleme çalışmalarına gereksinim vardır.
Night eating behavior and psychiatric comorbidity in patients with morbid obesity
Objective: The relationship between night eating syndrome (NES) and obesity resembles a vicious circle. The pre-sence of NES facilitates the shift to obesity, whereas the NES is more common in obese individuals. In the literature, the frequency of NES is reported as 2-20% in individuals with morbid obesity. In addition to obesity, the presence of NES was associated with higher depression scores and lower self-esteem. The aim of this study was to investi-gate the prevalence of NES and related factors in morbid obesity patients. Methods: In this study, 452 patients who applied for psychiatric evaluation before the bariatric surgery were evaluated. The presence of psychiatric disorder was assessed by a clinical interview conducted by a psychiatrist. Sociodemographic and clinical features such as age, gender, education level, body mass index were also recorded. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), Rosenberg Self Esteem Scale (RSES), and Night Eating Questionnaire (NEQ) were administered. Results: Fifty-nine (13%) of 452 morbid obesity patients were found to have NES. BDI, BAI, and RSES scores were significantly higher in the group with NES than without NES. In the group with NES, compared with non-NES; the rate of psychiatric disorder (44.1% and 26.2%, respectively) and depressive disorder (respect-tively, 25.4% and 13%) were significantly higher. The risk of developing NES in smokers increased by 3.05 fold; and a 1 unit increase in the BDI increases the risk of developing NES by 1.05 fold in the morbid obez sample. Discussion: In our study, it was found that comorbidity of NES in morbid obesity patients increased the risk of psychi-atric disease, especially depression, and self-esteem was worse in these patients. The fact that smoking is the highest predictor factor for the presence of NES is a finding that has been shown in other studies. The long-term follow-up studies are needed to investigate changes in depression, NES and eating patterns after bariatric surgery.

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