Альманах клинической медицины. 2014; : 3-7
ОСОБЕННОСТИ ПОВЕДЕНИЯ БОЛЬНЫХ С ИЗБЫТОЧНОЙ МАССОЙ ТЕЛА И ОЖИРЕНИЕМ
https://doi.org/10.18786/2072-0505-2014-32-3-7Аннотация
Актуальность. Прием пищи при ожирении входит в системы поведения более мощные, чем сознательный самоконтроль. Цель – исследовать особенности поведения больных ожирением, используя клинико-психопатологические и личностно-стилевые критерии. Материал и методы. Обследовано 149 пациентов с избыточной массой тела, обратившихся для лечения ожирения. Возраст больных составил от 19 до 69 лет. Их физическое состояние было удовлетворительным, а имеющиеся сопутствующие соматические заболевания – в стадии компенсации. Поведение больных оценивалось по диагностическим критериям МКБ-10, а также с помощью Методики многостороннего исследования личности (психологическое тестирование). Результаты. Установлено, что психические расстройства имелись у 98 (65,8%) больных. Особенно часто отмечались тревожные – у 65 (43,6%) и аффективные расстройства – у 41 (31,5%) пациента. При факторном анализе данных психологического тестирования было выделено пять основных типов поведения больных с избыточным весом и ожирением: пограничный, гипертимный, дистимический, сенситивный и недифференцированный. Ни выделенные типы поведения, ни частота психических расстройств не соответствовали степени ожирения. Заключение. Нарушения саморегуляции приема пищи при ожирении сопряжены с разными поведенческими стилями, не являющимися специфичными только для психических расстройств. В работе описаны эти стили и соответствующие им психологические механизмы переедания.
Список литературы
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11. Березин ФБ, Мирошников МП, Соколова ЕД. Методика многостороннего исследования личности. Структура, основы интерпретации, некоторые области применения. М.: Березин Феликс Борисович; 2011. (Berezin FB, Miroshnikov MP, Sokolova ED. [A method of the versatile studying of a personality. Structure, interpretation bases, and some fields for application]. Moscow: Berezin Feliks Borisovich; 2011. Russian).
12. Carpiniello B, Pinna F, Pillai G, Nonnoi V, Pisano E, Corrias S, Orrù MG, Orrù W, Velluzzi F, Loviselli A. Psychiatric comorbidity and quality of life in obese patients. Results from a case-control study. Int J Psychiatry Med. 2009;39(1):63-78.
13. Petry NM, Barry D, Pietrzak RH, Wagner JA. Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med. 2008;70(3):288-97.
14. Pickering RP, Goldstein RB, Hasin DS, Blanco C, Smith SM, Huang B, Pulay AJ, Ruan WJ, Saha TD, Stinson FS, Dawson DA, Chou SP, Grant BF. Temporal relationships between overweight and obesity and DSM-IV substance use, mood, and anxiety disorders: results from a prospective study, the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2011;72(11):1494-502.
15. Ayensa JI, Calderon MJ. Psychopathological comorbidity of obesity. An Sist Sanit Navar. 2011;34(2):253-61.
16. Henriksen CA, Mather AA, Mackenzie CS, Bienvenu OJ, Sareen J. Longitudinal associations of obesity with affective disorders and suicidality in the Baltimore epidemiologic catchment area follow-up study. J Nerv Ment Dis. 2014;202(5):379-85.
17. Leombruni P, Rocca G, Fassino S, Gastaldi F, Nicotra B, Siccardi S, Lavagnino L. An exploratory study to subtype obese binge eaters by personality traits. Psychother Psychosom. 2014; 83(2):114-8.
18. Brambilla F, Samek L, Company M, Lovo F, Cioni L, Mellado C. Multivariate therapeutic approach to binge-eating disorder: combined nutritional, psychological, and pharmacological treatment. Int Clin Psychopharmacol. 2009;24(6):312-7.
Almanac of Clinical Medicine. 2014; : 3-7
BEHAVIORAL PECULIARITIES IN PATIENTS WITH SURPLUS BODY MASS AND OBESITY
https://doi.org/10.18786/2072-0505-2014-32-3-7Abstract
Background: Eating in obesity represents behavioral systems more powerful than conscious self-control. Aim: To study the obese patients’ behavior with the help of clinical-psychopathological and personal style criteria. Materials and methods: A total of 149 patients (aged 19-69 years), who sought medical help due to obesity or overweight were examined. Their physical condition was satisfactory and concomitant somatic diseases were compensated. Patients’ behavior was assessed by diagnostic criteria ICD-10 as well as with a Minnesota Multiphasic Personality Inventory (psychological testing). Results: It was established that psychical impairments existed in 98 (65.8%) patients. The anxiety disorders (in 65 patients, 43.6%) and affective ones (in 41 patients, 31.5%) were noted most frequently. Factor analysis of the psychological test data revealed 5 main styles of behavior in patients with overweight and obesity: borderline, hyperthymic, dysthymic, sensitive, and undifferentiated. Neither these behavioral styles nor the frequency of disorders corresponded to the degree of obesity. Conclusion: Disturbances of eating self-regulation in obesity are associated with different behavioral styles, which are not specific for mental disorders only. These behavioral styles are described in the study as well as corresponding psychological mechanisms of overeating.
References
1. Vilhena E, Pais-Ribeiro J, Silva I, Cardoso H, Mendonça D. Predictors of quality of life in Portuguese obese patients: a structural equation modeling application. J Obes. 2014: 684919.
2. Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010;316(2):104-8.
3. Marcellini F, Giuli C, Papa R, Tirabassi G, Faloia E, Boscaro M, Polito A, Ciarapica D, Zaccaria M, Mocchegiani E. Obesity and body mass index (BMI) in relation to life-style and psycho-social aspects. Arch Gerontol Geriatr. 2009;49 Suppl 1:195-206.
4. Romantsova TI. Epidemiya ozhireniya: ochevidnye i veroyatnye prichiny. Ozhirenie i metabolizm. 2011(1): 5-19. (Romantsova TI. [Obesity epidemic: obvious and probable causes]. Ozhirenie i metabolizm. 2011(1):5-19. Russian).
5. Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J. Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol. 2007;62(3):220-33.
6. Peterson CB, Thuras P, Ackard DM, Mitchell JE, Berg K, Sandager N, Wonderlich SA, Pederson MW, Crow SJ. Personality dimensions in bulimia nervosa, binge eating disorder, and obesity. Compr Psychiatry. 2010;51(1):31-6.
7. Gurova OYu, Bobrov AE, Romantsova TI, Roik OV. Metabolicheskie i psikhopatologicheskie osobennosti bol'nykh morbidnym ozhireniem. Ozhirenie i metabolizm. 2007;(3):28-
8. (Gurova OYu, Bobrov AE, Romantsova TI, Roik OV. [Metabolic and psychopathologic features of the morbid obesity patients]. Ozhirenie i metabolizm. 2007;(3):28-32. Russian).
9. Vsemirnaya organizatsiya zdravookhraneniya. Mezhdunarodnaya klassifikatsiya boleznei (10-i peresmotr). Klassifikatsiya psikhicheskikh i povedencheskikh rasstroistv. SPb.: ADIS; 1994. (World Health Organization. International Statistical Classification of Diseases and Related Health Problems. 10th revision (ICD-10). Saint Petersburg: ADIS; 1994. Russian).
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11. Berezin FB, Miroshnikov MP, Sokolova ED. Metodika mnogostoronnego issledovaniya lichnosti. Struktura, osnovy interpretatsii, nekotorye oblasti primeneniya. M.: Berezin Feliks Borisovich; 2011. (Berezin FB, Miroshnikov MP, Sokolova ED. [A method of the versatile studying of a personality. Structure, interpretation bases, and some fields for application]. Moscow: Berezin Feliks Borisovich; 2011. Russian).
12. Carpiniello B, Pinna F, Pillai G, Nonnoi V, Pisano E, Corrias S, Orrù MG, Orrù W, Velluzzi F, Loviselli A. Psychiatric comorbidity and quality of life in obese patients. Results from a case-control study. Int J Psychiatry Med. 2009;39(1):63-78.
13. Petry NM, Barry D, Pietrzak RH, Wagner JA. Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med. 2008;70(3):288-97.
14. Pickering RP, Goldstein RB, Hasin DS, Blanco C, Smith SM, Huang B, Pulay AJ, Ruan WJ, Saha TD, Stinson FS, Dawson DA, Chou SP, Grant BF. Temporal relationships between overweight and obesity and DSM-IV substance use, mood, and anxiety disorders: results from a prospective study, the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2011;72(11):1494-502.
15. Ayensa JI, Calderon MJ. Psychopathological comorbidity of obesity. An Sist Sanit Navar. 2011;34(2):253-61.
16. Henriksen CA, Mather AA, Mackenzie CS, Bienvenu OJ, Sareen J. Longitudinal associations of obesity with affective disorders and suicidality in the Baltimore epidemiologic catchment area follow-up study. J Nerv Ment Dis. 2014;202(5):379-85.
17. Leombruni P, Rocca G, Fassino S, Gastaldi F, Nicotra B, Siccardi S, Lavagnino L. An exploratory study to subtype obese binge eaters by personality traits. Psychother Psychosom. 2014; 83(2):114-8.
18. Brambilla F, Samek L, Company M, Lovo F, Cioni L, Mellado C. Multivariate therapeutic approach to binge-eating disorder: combined nutritional, psychological, and pharmacological treatment. Int Clin Psychopharmacol. 2009;24(6):312-7.
