Trajectories of Resilience and Bariatric Surgery Outcomes

Study Overview
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Brief Summary
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A high prevalence of psychological trauma on one hand and of psychiatric disorders, such as depression, anxiety, suicide attempts, addictions, and eating disorders on the other hand, has been reported in patients with severe obesity seeking bariatric surgery. Some studies reported an increased prevalence of these psychiatric disorders after bariatric surgery, potentially related to weight regain. In this context, psychological resilience is a concept that brings together internal and external factors of adaptation, and whose clinical use facilitates interdisciplinary collaborative work. This research focuses on the association between resilience and success or failure of bariatric surgery in patients followed in the Specialized Obesity Center (CSO) of the Nancy University Hospital. The hypothesis is that psychological resilience before surgery promotes successful surgical treatment. This retrospective study is based on existing data from patients with severe obesity who have undergone bariatric surgery at the Nancy CSO. The main objective is to study 1) the resilience of patients with severe obesity, candidates for bariatric surgery, at the first assessment (T0), at the end of lifestyle/behavioral modifications program (T1) and at 2 years after bariatric surgery (T2), 2) the relationship between internal and external factors explaining resilience and final weight outcomes. The investigators are expected that non-resilient patients have more psychological vulnerabilities (psychopathology, negative life events, etc.), and have lower weight loss than resilient patients.

Detailed Description
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The investigators will report the change of resilience during lifestyle/behavioral modifications program and 2 years after bariatric surgical treatment, and the investigators will describe the factors associated with this change: History of trauma Psychopathology (eating disorders, depression, anxiety, addiction) Personality factors Characteristic of psychotherapy

Official Title
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Resilience Trajectories Following a Preoperative Lifestyle /Behavioral Modification Program and Bariatric Surgery

Conditions
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Severe Obesity, Psychological Distress, Bariatric Surgery Candidate

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Severe obesity (BMI ≥35 kg/m2) Candidate for Bariatric surgery at Nancy CSO (2016-2020) after a lifestyle/behavioral modifications program Full psychological assessment data Exclusion Criteria: Patient's opposition to the use of data for research purposes

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resilience (Questionnaire) : Resilience Scale for Adult (RSA) | Min: 33 ; Max: 231; Higher scores mean a better outcome Score of resilience (Resilience Scale for adults) and level of resilience (non-resilient, intermediate, resilient) / number of patients in each category | baseline (T0) | 
| Resilience (semi-structured interview) : level of resilience | Categories : Non-resilient, intermediate, resilient Number and % of patients in each category | baseline (T0) | 
| Resilience (Questionnaire) : Resilience Scale for Adult (RSA) | Min: 33 ; Max: 231; Higher scores mean a better outcome | 10 months (T1) | 
| Resilience (semi-structured interview) : level of resilience | Categories : Non-resilient, intermediate, resilient Number and % of patients in each category | 10 months (T1) | 
| Resilience (Questionnaire) : Resilience Scale for Adult (RSA) | Min: 33 ; Max: 231; Higher scores mean a better outcome. | 2 years after surgery (T2) | 
| Resilience (semi-structured interview) : level of resilience | Categories : Non-resilient, intermediate, resilient Number and % of patients in each category | 2 years after surgery (T2) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital Anxiety and Depression scale (HAD) | Min: 0 ; Max: 42; Higher scores mean a worse outcome. | baseline (T0) | 
| Dutch Eating Behaviour Questionnaire (DEBQ) | Min: 33 ; Max: 165 ; Higher scores mean a worse outcome | baseline (T0) | 
| Binge eating scale (BES) | Min: 0 ; Max: 48 ; Higher scores mean a worse outcome. | baseline (T0) | 
| Mini International Neuropsychiatric Interview (semi-structured interview) | Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders). | baseline (T0) | 
| Psychological trauma (semi-structured interview) | Number and % of patients in each category (Sexual, physical, emotional abuse, emotional and physical neglect) Number and % of patients in each category for the first trauma (childhood, adolescence, adulthood) | Baseline (T0) | 
| Childhood Trauma Questionnaire (CTQ) | Min: 25 ; Max: 125 ; Higher scores mean a worse outcome | baseline (T0) | 
| Toronto Alexithymia Scale (TAS) | Min: 20 ; Max: 100 ; Higher scores mean a worse outcome | baseline (T0) | 
| Medical Outcomes Study Short Form (SF-36) | Min: 0 ; Max: 100 ; Higher scores mean a better outcome. | baseline (T0) | 
| Definition of patient's psychological profile : clinical interviews | Profile is determined by clinical interviews | baseline (T0) | 
| Definition of patient's psychological profile : Rorschach test | Profile is determined by Rorschach test | baseline (T0) | 
| Characteristics of psychotherapy : Duration | Duration of psychotherapy (month) | baseline (T0) | 
| Characteristics of psychotherapy : Frequency | Frequency of psychotherapy (number of sessions per month) | baseline (T0) | 
| Characteristics of psychotherapy: Type of professional | Type of professional (Psychiatrist, Psychologist, Nurse, Other) | baseline (T0) | 
| Characteristics of psychotherapy : Investment | Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome. | baseline (T0) | 
| Sex | men/women | baseline (T0) | 
| Age | years | baseline (T0) | 
| Professional situation | Active / Unemployed / Homemaker / Retired / Unable to work | baseline (T0) | 
| Family situation | Currently married/cohabiting / Formerly married / Never married | baseline (T0) | 
| Weight data | Weight: kg BMI: kg/m² | baseline (T0) | 
| Hospital Anxiety and Depression scale (HAD) | Min: 0 ; Max: 42; Higher scores mean a worse outcome | 10 months (T1) | 
| Dutch Eating Behaviour Questionnaire (DEBQ) | Min: 33 ; Max: 165 ; Higher scores mean a worse outcome | 10 months (T1) | 
| Binge eating scale (BES) | Min: 0 ; Max: 48 ; Higher scores mean a worse outcome | 10 months (T1) | 
| Mini International Neuropsychiatric Interview | • Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders). | 10 months (T1) | 
| Toronto Alexithymia Scale (TAS) | Min: 20 ; Max: 100 ; Higher scores mean a worse outcome. | 10 months (T1) | 
| Medical Outcomes Study Short Form (SF-36) | Min: 0 ; Max: 100 ; Higher scores mean a better outcome. | 10 months (T1) | 
| Definition of patient's psychological profile :clinical interviews | Profile is determined by clinical interviews | 10 months (T1) | 
| Definition of patient's psychological profile : Rorschach test | Profile is determined by Rorschach test | 10 months (T1) | 
| Characteristics of psychotherapy: Duration | Duration of psychotherapy (month) | 10 months (T1) | 
| Characteristics of psychotherapy: Frequency | Frequency of psychotherapy (number of sessions per month) | 10 months (T1) | 
| Characteristics of psychotherapy: Type of professional | Type of professional (Psychiatrist, Psychologist, Nurse, Other) | 10 months (T1) | 
| Characteristics of psychotherapy: Investment | Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome. | 10 months (T1) | 
| Professional situation | Active / Unemployed / Homemaker / Retired / Unable to work | 10 months (T1) | 
| Family situation | Currently married/cohabiting / Formerly married / Never married | 10 months (T1) | 
| Weight data | Weight: kg BMI: kg/m² | 10 months (T1) | 
| Hospital Anxiety and Depression scale (HAD) | Min: 0 ; Max: 42; Higher scores mean a worse outcome. | 2 years after surgery (T2) | 
| Dutch Eating Behaviour Questionnaire (DEBQ) | Min: 33 ; Max: 165 ; Higher scores mean a worse outcome. | 2 years after surgery (T2) | 
| Binge eating scale (BES) | Min: 0 ; Max: 48 ; Higher scores mean a worse outcome. | 2 years after surgery (T2) | 
| Mini International Neuropsychiatric Interview | • Number and % of patients in each category (major depressive episode, dysthymia, suicidal risk, bipolar disorder, panic disorder, agoraphobia, social phobia, obsessive compulsive disorder, post-traumatic stress disorders, alcohol (addiction/abuse), drugs (addiction/abuse), psychotic disorders, generalized anxiety, anti- social personality disorders, eating disorders). | 2 years after surgery (T2) | 
| Toronto Alexithymia Scale (TAS) | Min: 20 ; Max: 100 ; Higher scores mean a worse outcome. | 2 years after surgery (T2) | 
| Medical Outcomes Study Short Form (SF-36) | Min: 0 ; Max: 100 ; Higher scores mean a better outcome. | 2 years after surgery (T2) | 
| Definition of patient's psychological profile : clinical interviews | Profile is determined by clinical interviews | 2 years after surgery (T2) | 
| Definition of patient's psychological profile : Rorschach test | Profile is determined by Rorschach test | 2 years after surgery (T2) | 
| Characteristics of psychotherapy: Duration | Duration of psychotherapy (month) | 2 years after surgery (T2) | 
| Characteristics of psychotherapy: Frequency | Frequency of psychotherapy (number of sessions per month) | 2 years after surgery (T2) | 
| Characteristics of psychotherapy: Type of professional | Type of professional (Psychiatrist, Psychologist, Nurse, Other) | 2 years after surgery (T2) | 
| Characteristics of psychotherapy: Investment | Investment in psychotherapy (0:bad ; 5: excellent) Min: 0 ; Max: 5 ; Higher scores mean a better outcome. | 2 years after surgery (T2) | 
| Professional situation | Active / Unemployed / Homemaker / Retired / Unable to work | 2 years after surgery (T2) | 
| Family situation | Currently married/cohabiting / Formerly married / Never married | 2 years after surgery (T2) | 
| Weight data | Weight: kg BMI: kg/m² | 2 years after surgery (T2) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Severe obesity, Resilience, Trauma, Psychological disorders, Eating disorders, Bariatric surgery