A latent class analysis of psychiatric symptoms among 125 adolescents in a bariatric surgery program

Sysko, Robyn; Zakarin, E. Blake; Devlin, Michael J.; Bush, Jennifer; Walsh, B. Timothy

doi:10.3109/17477166.2010.545411

Cited by 35 publications

(41 citation statements)

References 58 publications

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“…The study also aimed to examine predictors and correlates of postoperative visit attendance. We predicted that subgroups demonstrating different attendance patterns would be identified within the sample based on previous research demonstrating heterogeneity among adolescent surgical candidates (e.g., 25). In addition, we hypothesized that like adults receiving bariatric surgery (6, 14) or adolescents with chronic health problems (21–24) , psychosocial problems such as elevated depressive symptoms, low levels of quality of life, and eating pathology would predict adherence post-LAGB.…”

Section: Introductionmentioning

confidence: 99%

Predictors and correlates of follow-up visit adherence among adolescents receiving laparoscopic adjustable gastric banding

Sysko

Hildebrandt

Kaplan

et al. 2014

Surgery for Obesity and Related Diseases

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Background Adherence behaviors have not been examined among adolescents undergoing laparoscopic adjustable gastric banding (LAGB). In addition, studies of youth receiving bariatric surgery have not considered the influence of psychopathology on postoperative adherence. Objective The purpose of this study was to evaluate predictors and correlates of adherence to post-surgery visits among a sample of adolescents undergoing LAGB. Setting Psychiatry Department, University Medical Center, United States. Methods Postoperative visits with surgical staff were analyzed over the two years following surgery (n= 101 adolescents). Growth mixture modeling examined trends in adherence. Results A three-class solution provided the best fit to the data. The classes from the final model were characterized by class 1 (61.6%) demonstrating high levels of adherence over the 24 months following LAGB, class 2 (28.5%) showing a more gradual decline in adherence, and class 3 (9.9%) with an accelerated decline in adherence. Higher levels of preoperative depressive symptoms and more preoperative episodes of loss of control over eating decreased the likelihood of adherence. Class 3 adolescents had significantly higher estimated 24-month body mass indices than Classes 1 or 2. Conclusions Variable patterns of follow-up visit adherence were identified among adolescents receiving LAGB, which were predicted by depressive symptoms and loss of control over eating. The trajectory characterized by a rapid decline in adherence to follow-up visits was also associated with less weight loss.

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Section: Introductionmentioning

confidence: 99%

Predictors and correlates of follow-up visit adherence among adolescents receiving laparoscopic adjustable gastric banding

Sysko

Hildebrandt

Kaplan

et al. 2014

Surgery for Obesity and Related Diseases

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“…The literature on eating behaviors in AYAs with severe obesity is limited, although initial evidence has begun to emerge regarding targeted eating behaviors (i.e., binge eating, a sense of loss of control; LOC) that may be relevant to weight loss surgery outcomes in AYAs with severe obesity. While these initial reports suggest that youth with severe obesity presenting for weight loss surgery may present similarly as children and adolescents who are overweight and obese in terms of prevalence rates (Zeller et al, 2015; Kim et al, 2008) and psychosocial correlates (Sysko, Zakarin, Devlin, Bush, & Walsh, 2011; Sysko et al, 2012), there have been few studies to our knowledge that comprehensively characterize the eating behaviors and patterns among AYAs with severe obesity.…”

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confidence: 99%

Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity

et al. 2016

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Objective Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. Methods Fifty-four AYA females with severe obesity (MBMI=48.71 kg/m2; Mage=18.29, R=15–21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. Results Breakfast was the most frequently skipped meal (consumed 3–4 times/week). Eating out was common (4–5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. Conclusions Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional impact on functioning (e.g., psychosocial health, weight loss behaviors).

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“…Homogeneous subgroups with distinct patterns of psychopathology were found among youth pre-surgery 9 , suggesting that variability in psychiatric symptoms could influence weight change following LAGB. The purpose of the current study was to comprehensively examine psychiatric symptoms in a large sample of adolescents in the year following LAGB by evaluating changes in depressive symptoms and quality of life and the interaction between patterns of change in depression, quality of life, and weight.…”

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confidence: 99%

Psychological Outcomes and Predictors of Initial Weight Loss Outcomes Among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

Sysko¹,

Devlin²,

Hildebrandt³

et al. 2012

J. Clin. Psychiatry

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Objective Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery. The role of mental health providers in this population is not well defined, and the selection of candidates is often the result of clinical judgment alone. The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric banding (LAGB) by: (1) examining changes in depressive symptoms and quality of life in the year following surgery, (2) evaluating the interaction between patterns of change in depression, quality of life, and weight post-surgery, and (3) identifying pre-surgical psychological predictors of initial weight change. Method Participants were 101 severely obese adolescents aged 14 to 18. Measures of height, weight, depressive symptoms, and quality of life were obtained in the first year following surgery. Changes in the Beck Depression Inventory (BDI), Pediatric Quality of Life Inventory (PedsQL), and body mass index were analyzed using latent growth curve modeling. Results Significant changes in total BDI [βslope=−0.885 SE=0.279, p<0.01; βquadratic=0.054 SE=0.021, p<.001] and PedsQL [βslope=−0.885 SE=0.279, p<0.001] scores were observed following LAGB, and comparable post-operative changes between psychosocial variables and body mass index were also noted [BDI: COV=0.21, SE=0.06, p<0.001; PedsQL: COV=−0.41, SE=0.10, p<0.01]. Two variables (family conflict/loss of control eating) were found to be significant predictors of weight change over the year following surgery (p<0.05). Conclusion Adolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB, and measures of pre-operative binge eating and family conflict affected post-surgery body mass index among youth.

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A latent class analysis of psychiatric symptoms among 125 adolescents in a bariatric surgery program

Cited by 35 publications

References 58 publications

Predictors and correlates of follow-up visit adherence among adolescents receiving laparoscopic adjustable gastric banding

Predictors and correlates of follow-up visit adherence among adolescents receiving laparoscopic adjustable gastric banding

Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity

Psychological Outcomes and Predictors of Initial Weight Loss Outcomes Among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

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