减肥手术后强迫行为形式的变化最好用大脑奖励周期的缺乏来描述

P. Korenis
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引用次数: 0

摘要

肥胖相关合并症的患病率在美国已达到流行水平,34.9%的人肥胖。手术干预是治疗病态肥胖最有效的方法。2003年至2010年间,每年有113000例患者接受减肥手术。一些研究表明,手术后的长期总死亡率降低,尤其是心脏病、糖尿病和肿瘤的死亡率。然而,其他原因造成的死亡率更高;自杀是主要因素。在这里,我们介绍了一个41岁的女性,在减肥手术后,由于酗酒和自杀企图而反复住院。她在醉酒后试图从楼顶跳下,随后被我们接纳。一个月前,她因同样的原因在另一家医院住院。她对心理社会支持、心理教育、学习应对技能和团体支持治疗反应良好。她的治疗方案包括使用无草甘膦、锂和利培酮。她报告说,焦虑和愤怒减少了,睡眠周期改善了,判断和冲动控制也改善了。我们用这个案例来说明,非常需要确定减肥手术后精神病发病的风险因素,并鼓励临床医生注意减肥手术后的潜在发展,并确保对这些高危患者进行精神随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Change in form of compulsive behavior after bariatric surgery is a phenomena best describe by deficiency of reward cycle in the brain
The prevalence of obesity related comorbidities has reached epidemic levels in the USA, 34.9% of people are obese. Surgical intervention is the most efficient management of morbid obesity. Between 2003 and 2010, 113,000 cases per year underwent bariatric surgery. Some studies suggest long-term total mortality rate is reduced after surgery, particularly deaths from heart disease, diabetes, and neoplasms. However, the rate of death from other causes was higher; suicide is the main contributing factor. Here we present a case of 41-year-old female with recurrent psychiatric hospitalizations due to Alcohol abuse and suicidal attempts after bariatric surgery. She was admitted to our service after she attempted to jump from the roof of her building while intoxicated with Alcohol. A month prior, she was hospitalized in another hospital for the same reason. She responded well to psychosocial support, psychoeducation, learning coping skills, and group supportive therapy. Her treatment regimen included the use of acamprosate, lithium, and risperidon. She reported a decrease in anxiety and anger, an improved sleep cycle, and improved judgment and impulse control. We use this case to illustrate the great need to identify the risk factors for psychiatric morbidity after bariatric surgery and encourage clinicians to be mindful of this potential development after bariatric surgery and ensure psychiatric follow up for these at risk patients.
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