Microscopic colitis (MC) constitutes the main entities collagenous colitis (CC) and lymphocytic colitis (LC), diseases that are relatively recently described (in 1976 and 1989, respectively). The aims of this thesis were to study the epidemiology of MC, to describe how these diseases affect patients in terms of symptom burden and health-related quality of life (HRQoL), to study potential risk factors such as familial factors, childhood circumstances, educational level, marital status, smoking and comorbidity, and to describe a cohort of patients with ulcerative colitis (UC) or Crohn’s disease (CD) and subsequent MC, and vice versa. During 1999–2008 in Sweden, the mean annual incidence of MC was 10.2 per 105 inhabitants, compared with 5.2 per 105 inhabitants for CC, and 5.0 per 105 inhabitants for LC. The prevalence of MC on 31 December 2008 was 123 per 105 inhabitants. Women appeared to be especially affected – the female:male ratio was 3.6:1 in CC and 4.6:1 in LC. Patients’ HRQoL is impaired both in active CC and in LC. Patients with CC in clinical remission have persisting symptoms: abdominal pain, fatigue, arthralgia and myalgia; LC patients in remission have persistent fatigue compared with controls. This illustrates that the longterm outcome is different in CC compared with LC. Microscopic colitis is associated with a family history of MC, indicating that familial factors may play a role in the pathogenesis of this disease. We confirm earlier reports that smoking is a risk factor in MC. In the present study population, CC was associated with rheumatic disease and previous appendicectomy. Moreover, CC and LC were associated with thyroid disease and coeliac disease and, interestingly, with a history of UC. Most patients with UC or CD and subsequent MC, or vice versa, had UC or CD first and later developed MC. The majority had extensive UC and later onset of CC. Microscopic colitis should be considered in patients with UC or CD if there is onset of chronic watery diarrhoea without endoscopic relapse of mucosal inflammation.

<p>Hronična bubrežna bolest (HBB) je globalni zdravstveni problem ne toliko zbog svoje masovnosti, koliko zbog hroničnog, progresivnog toka i udrženosti sa značajnim komorbiditetima. Anemija u sklopu HBB povezana je sa smanjenim kvalitetom života, povećanjem kardiovaskularnog morbiditeta, kognitivnim poremećajima, povećanjem broja hospitalizacija i sa povećanim mortalitetom. Incidencija anemije raste sa napredovanjem HBB, tako da u petom stadijumu zahvata gotovo sve obolele. Hepcidin je centralni regulator metabolizma gvožđa u organizmu, koji može uticati na razvoj i lečenje anemije u sklopu HBB. Cilj istraživanja je bio da se utvrdi nivo hepcidina kod ispitivanih bolesnika, kao i njegova povezanost sa parametrima metabolizma gvožđa, markerima inflamacije i odgovorom na agense za stimulaciju eritropoeze (ESA). Istovremeno smo želeli da utvrdimo koji faktori utiču na nivo hemoglobina u ispitivanoj populaciji, kao i &scaron;ta utiče na indeks rezistencije na eritropoetin (ERI). U ispitivanje je uključeno 77 bolesnika koji su lečeni hroničnim programom hemodijalize, tokom najmanje tri meseca pre uključivanja u ispitivanje. Ispitanicima je metodom ELISA određen nivo hepcidina u serumu. Ostali ispitivani podaci su dobijeni anamnezom, fizikalnim pregledom, analizom medicinske dokumentacije i standardnim laboratorijskim ispitivanjima. Sprovedenim ispitivanjem smo utvrdili postojanje pozitivne korelacije između serumskog nivoa hepcidina i interleukina-6, dok ostali ispitivani parametri inflamacije nisu korelirali sa nivoom hepcidina. Od parametara metabolizma gvožđa, sa serumskim nivoom hepcidina pozitivno su korelirali nivo gvožđa u serumu, feritin i saturacija transferina, dok je utvrđena negativna korelacija sa transferinom i ukupnim kapacitetom za vezivanje gvožđa. Serumski nivo hepcidina pozitivno je korelirao sa prosečnom nedeljnom dozom ESA. Nije utvrđena korelacija sa ERI, ukupnom dužinom lečenja sa ESA, kao ni sa vrstom ESA. Od svih ispitivanih parametara koji su značajno korelirali sa nivoom hepcidina u serumu, multivarijantna analiza je izdvojila jedino nivo feritina kao signifikantan i nezavisan činilac. Hemoglobin u krvi bolesnika koji su uključeni u ispitivanje nezavisno pozitivno korelira sa vrednostima leukocita i albumina u serumu. Vrednosti ERI u ispitivanoj grupi pozitivno koreliraju sa paratiroidnim hormonom, a negativno sa vrednostima leukocita i indeksom telesne mase.</p> / <p>Chronic kidney disease (CKD) is a global health problem not so much because of its massiveness, as a chronic, progressive course and association with significant comorbidities. Anemia associated with the CKD leads to reduced quality of life, increase in cardiovascular morbidity, cognitive impairment, an increase in the number of hospitalizations and increased mortality. The incidence of anemia increases with the progression of CKD, and in the fifth stage affects almost all the patients. Hepcidin is a central regulator of iron metabolism in the body, which may affect the development and treatment of anemia in CKD. The aim of this study was to determine the level of hepcidin in the patients, as well as its association with parameters of iron metabolism, markers of inflammation and response to erythropoiesis-stimulating agents (ESA). Also, we wanted to determine what factors influence the level of hemoglobin in the study population, as well as what affects the erythropoietin resistance index (ERI). The study included 77 patients who were treated with chronic hemodialysis for at least three months prior to inclusion in the study. Serum hepcidin levels were determined by the ELISA procedure. Other test data were obtained by anamesis, physical examination, analysis of medical history and standard laboratory tests. In our study we have found a positive correlation between serum levels of hepcidin and interleukin-6, while the other parameters of inflammation did not correlate with the level of hepcidin. Serum hepcidin levels were positively correlated values of serum iron, ferritin, transferring saturation, and negatively correlated with transferring and total iron binding capacity. Serum hepcidin levels positively correlated with average weekly dose of ESA. There was no correlation with ERI, the total length of treatment with ESA, as well as the type of ESA. Of all the tested parameters that were significantly correlated with the level of hepcidin in serum, multivariate analysis has allocated only ferritin level as a significant and independent factor. The hemoglobin in the blood of the patients involved in the study, positively correlated with the values of the white cell count and serum albumin. ERI values in the study group positively correlated with parathyroid hormone, and negatively with the values of leukocytes and body mass index.</p>

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Il y a peu de recherche sur la comorbidité concomitante entre les problèmes de santé mentale et la dépression, tels que perçus par les adolescents de 12-15 ans. L’objectif de cette étude est d’effectuer des analyses secondaires pour vérifier l’association entre quatre problèmes de santé mentale (phobies spécifiques (PS), anxiété généralisée (AG), opposition avec provocation (OP), problème des conduites (PC)) et la dépression ainsi que les interactions de ces associations avec l’âge (12-13 ans; 14-15 ans) et le sexe. Ces problèmes ont été évalués par le Dominique Interactif pour Adolescents (DIA), un questionnaire informatisé et auto-administré. L’analyse de la régression logistique a été réalisée séparément dans un échantillon clinique (n=141) et dans un échantillon scolaire (n=464) composés d’adolescents francophones. Les résultats indiquent un effet d’interaction significatif dans l’échantillon clinique suggérant que les filles ont trois fois plus de chance d’avoir une comorbidité entre les PS et la dépression comparativement aux garçons. Les modèles multivariés révèlent que pour les autres associations, la comorbidité ne varie pas significativement selon l’âge et le sexe. Cependant, dans les deux échantillons, une forte association entre AG, OP, ou PC et la dépression a été observé indépendamment de l’âge et du sexe, ce qui suggère l’importance de la comorbidité globale entre ces problèmes. L’utilisation du DIA pour évaluer la perception des adolescents concernant leurs problèmes de santé mentale représente une contribution originale de cette étude. Les résultats obtenus suggèrent que l’évaluation clinique de la comorbidité devrait inclure l’information provenant de l’adolescent. / There is a lack of research on concurrent comorbidity between mental health problems and depression in youth aged 12-15 years based on adolescent-reports. The objective of this study is to assess the presence of this type of comorbidity and its variation across age and sex subgroups. Secondary analyses were conducted to examine the associations between four mental health problems (specific phobia (SPh), generalized anxiety (GAD), oppositional (ODD) and conduct disorders (CD) and depression, as well as interaction effects with age-groups (12-13 years; 14-15 years) and sex. Mental health problems were measured by the Dominic Interactive for Adolescents (DIA), a highly structured computerized self-report measure. Multivariate logistic regression models were built separately in clinical (n=141) and school (n=464) samples of French-speaking adolescents. There was a significant interaction effect in the clinical sample suggesting that girls were 3 times more likely to present comorbidity between SPh and depression compared to boys. Multivariate models revealed that for other patterns of comorbidity, there was no significant variation of comorbidity across age or sex subgroups. In both samples, global comorbidity was found for GAD, CD, or ODD and depression. Findings highlighted an important comorbidity between anxiety or disruptive problems and depression regardless of age and sex. Measuring the perception of these problems by adolescents aged 12-15 years using the DIA represents an original contribution. It suggests that clinical evaluation of comorbidity should take into account adolescent-reports.

The aim of this research is the occurrence of symptoms of the limbic dysfunction in patients suffering from headaches. By means of the questionnaire survey method was tested group of people with this diagnosis. The basic premise is the assumption that certain symptoms, specifically abnormalities in brain activity, occur more frequently in patients with this diagnosis. The theoretical part of this thesis concentrates on the function of the temporal lobe and the limbic system, a brief outline of the characteristics of temporo-limbic dysfunction and a summary overview of headaches. The research part is addressed to the evaluation questionnaire study and answers to the questions asked. Keywords Temporal lobe, limbic system, temporolimbic dysfunction, headaches, migraine, comorbidity,questionnaire

Every year 16 000 individuals receive a total hip arthroplasty (THA) in Sweden. Even though THA is a common procedure, adverse events do occur. The most dramatic complication is death in the postoperative phase. The overall aim of this thesis was to describe and investigate early mortality after THA in Sweden. Sweden has an ideal platform for national observational registry studies, thanks to the use of personal identity numbers. Operation-specific information was collected from the Swedish Hip Arthroplasty Register, medical information from the National Board of Health and Welfare, and socioeconomic information was collected from Statistics Sweden. Main outcome was 90-day mortality. Study I was a prospective observational register study investigating the risk of mortality after a simultaneous bilateral THA compared with staged bilateral THA. There was no clinically relevant difference in early postoperative mortality between the two groups. Studies II and III were nation-wide matched cohort studies, with adjustment for comorbidity and socioeconomic background. Adjusted early mortality in femoral neck fracture patients receiving a THA is about double compared with a matched control population. Young (60-69 years) femoral neck fracture patients receiving a THA have a low absolute mortality risk, while those who are older than 80 years with a higher degree of medical comorbidity run a high risk of early death (II). In study III healthier, younger patients with higher socioeconomic status tended to be selected for cementless THA, resulting in selection bias. Even after accounting for this bias, however, there remains a small absolute and adjusted increase in the risk of death within 14 days after elective THA surgery using fully cemented implants. Study IV was a nationwide prospective cohort study comparing different comorbidity measures in terms of predicting early postoperative mortality after THA. A less data-demanding comorbidity measure is better at predicting 90-day mortality than more commonly used coding algorithms. In conclusion, socioeconomic background and the presence of comorbidities have an important influence on early mortality after THA, while the type of fixation is of less importance. Future mortality studies could benefit from the use of data that are routinely collected, and thus avoid the logistically complicated procedure now necessary to merge national databases.

Bakgrund: Psykisk ohälsa ökar i samhället och är den främsta orsaken till sjukskrivningar i Sverige. Patienter med psykisk ohälsa har troligtvis ett större behov av somatisk vård än andra grupper i befolkningen, då många lever med samtidig fysisk ohälsa. Vidare upplever patienter att stigma, tidsbrist samt sjuksköterskors bristande kunskap utgör hinder för god vård inom somatisk kontext. Syfte: Syftet var att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa i somatisk hälso- och sjukvård. Metod:En systematisk litteraturstudie med beskrivande syntes utifrån Evans analysprocess. Tolv vårdvetenskapliga artiklar analyserades och finns presenterade i resultatet. Resultat: Tre teman med två subteman vardera identifierades. De teman som identifierades var; Sjuksköterskors kompetens, Patienters inverkan samt Organisation och struktur. Slutsats: Det framkom att sjuksköterskor upplevde att deras kunskap- och tidsbrist samt patienters bristande delaktighet i vården leder till att behov hos patienter med psykisk ohälsa inte blir tillgodosedda. / Background: Mental illness is increasing in society and is the main cause for sick leave in Sweden. Patients with mental illness probably have a greater need for somatic healthcare than other groups in society, as many patients live with contemporary physical illness. Furthermore, patients find that stigma, lack of time and nurses’ lack of knowledge constitute barriers towards good care in somatic context. Aim: The aim of this study was to describe nurses experiences of nursing patients with mental illness in somatic healthcare. Method:A systematic literature study with descriptive synthesis according to Evans synthesis process. Twelve qualitative articles were analyzed and are presented in the results. Results: Three themes with two sub themes each were identified. The themes identified were; Nurses competence, Patients impact and Organization and structure. Conclusions: Nurses experience that their lack of knowledge and time together with patients lack of participation has led to the needs of patients with mental illness not being met.

A associação entre transtornos alimentares e dependência de substâncias, psicoativas tem sido freqüentemente relatada tanto em programas para dependência química, como em serviços para transtornos alimentares. No entanto, há grande variabilidade entre os diferentes estudos. Uma das hipóteses que tem sido levantada para explicar essa diversidade é que em dependentes de substâncias a associação mais freqüente seria com síndromes alimentares parciais ou subclínicas. Praticamente não há pesquisas que avaliem a influência dessa comorbidade na evolução do tratamento para dependência química. O objetivo deste estudo é comparar o perfil de três grupos de mulheres dependentes de substâncias psicoativas - com comorbidade com transtornos alimentares clínicos, com comorbidade com patologia alimentar subclínica e sem essa comorbidade - e descrever sua evolução em um programa especializado para dependência química feminina. MÉTODO: foram estudadas 80 mulheres dependentes de álcool e drogas que procuram tratamento no Programa de Atenção à Mulher Dependente Química (PROMUD) do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da USP. As pacientes foram avaliadas para a coleta de dados sócio-demográficos e relativos ao uso de substâncias psicoativas através de um questionário padronizado; para diagnóstico clínico, através da Entrevista Clínica Estruturada para o DSM-IV (SCID), e subclínico, do Teste de Atitudes Alimentares (EAT) e do Teste de Investigação Bulímica (BITE); para avaliação da imagem corporal através do Questionário de Imagem Corporal (BSQ); para evolução, através da Addiction Severity Index (ASI) e da Escala de Seguimento de Alcoolistas (ESA-M e ESA-Drogas). RESULTADOS: 27 (33,75%) pacientes tinham transtornos alimentares clínicos, 17 (21,25%) tinham patologia alimentar subclínica e 36 (45%) não tinham essa comorbidade. Os resultados mostraram que o grupo com transtorno alimentar clínico era significativamente mais jovem, tinha maior severidade no uso de álcool e tendência para maior gravidade no uso de drogas. O grupo subclínico diferia dos outros dois somente por apresentar uma situação ocupacional pior. Após um ano foram verificadas mudanças significativas no comportamento e padrão alimentar do grupo subclínico e na imagem corporal do grupo com transtorno alimentar clínico. Não foram observadas diferenças entre os três grupos na permanência em um ano de tratamento e todos melhoraram significativamente no uso de substâncias em 12 meses. No entanto, as pacientes do grupo com transtornos alimentares clínicos tiveram uma evolução mais lenta. CONCLUSÕES: Estes dados não apóiam a hipótese de que a associação com transtornos alimentares afete o curso do tratamento de mulheres dependentes, sugerindo que uma abordagem integrada, que responda às necessidades de forma pessoal e individualizada, tem mais chances de sucesso. / The association between eating disorders and psychoactive substance dependence has often been described in both chemical dependence and eating disorders treatment programs. As studies show great result variability it has been suggested that substance dependent individuals would have frequently associated partial or subclinical eating syndromes. There is virtually no research exploring the impact of such comorbidity in the treatment outcome of chemical dependent individuals. The present study aimed at comparing three groups of psychoactive substance dependent women - those with comorbid clinical eating disorders, those with comorbid subclinical eating condition and those with no comorbid disorder - and describing their outcome in a program targeted for chemical dependent women. METHODS: A total of 80 alcohol and drug dependent women who sought treatment at the Drug Dependent Women Treatment Center (PROMUD) of Clínicas Hospital?s Psychiatry Institute of the University of São Paulo Medical School were studied. Sociodemographic and psychoactive substance use data were collected using a standardized questionnaire. The clinical diagnosis was made using the Structured Clinical Interview for the DSM-IV (SCID) and subclinical diagnosis was made using the Eating Attitude Test (EAT) and the Bulimic Inventory Test of Edinburgh (BITE). Body self-image was assessed using the Body Shape Questionnary (BSQ) and treatment outcome was assessed using the Addiction Severity Index (ASI) and Alcohol Dependence Follow-up Scale (AFS-M and AFS-Drugs). RESULTS: Twenty-seven (33.75%) patients had clinical eating disorders, 17 (21.25%) had subclinical eating condition and 36 (45%) had no comorbid condition. The clinical eating disorder group showed to be significantly younger and had more severe alcohol and drug use. The subclinical group had only a poorer occupational status when compared to the other two groups. One-year follow-up showed significant behavior and eating pattern changes in the subclinical group and body self-image changes in the clinical eating disorder group. No differences were seen as for the length of stay in treatment during the course of a year in the three groups and all patients improved significantly substance use after a 12-month-period, though clinical eating disorder patients had a much slower progress. CONCLUSIONS: The study findings don?t support the assumption that the association between eating disorders affects treatment outcome among substance dependent women, suggesting that a comprehensive approach focusing on the individual?s personal needs and delivered in a customized manner would be more likely to succeed.

A associação entre epilepsia e transtornos psicóticos é amplamente relatada na literatura. Características clínicas e do seu impacto, tais como suicídio, tentativas de suicídio, homicídio e alterações cognitivas são evidenciados em poucos estudos que associam epilepsia e psicose. Este estudo comparou o impacto clínico e funcionamento psicossocial dos pacientes com epilepsia e transtornos psicóticos, analisando ainda as diferenças entre pacientes com psicose interictal e pós-ictal. O estudo consiste de uma revisão de prontuário de todos os pacientes atendidos no PRONEPSI com epilepsia e transtornos mentais. Foram estudados 143 indivíduos, divididos em dois grupos: 82 pacientes com diagnóstico de epilepsia e transtornos psicóticos e 61 pacientes com epilepsia e outro transtorno mental. O grupo de pacientes psicóticos foi estudado comparando dados entre pacientes com psicose interictal (53) e pós-ictal (17). O grupo de pacientes com transtornos psicóticos apresentou menor escolaridade, mais história familiar de psicose, maior número de tentativas de homicídio, mais estados de mal epiléptico, mais internações psiquiátricas, história pregressa de insulto ao SNC e retardo mental. Além disso, a epilepsia foi considerada um fator causal importante para desenvolvimento da psicose. O grupo de pacientes com transtornos psicóticos também se diferenciou, revelando maior impacto na esfera cognitiva, vocacional e pessoal. Os pacientes com psicose interictal tiveram mais história familiar para psicose e a epilepsia foi considerada um fator causal importante para seu desenvolvimento. Pacientes com epilepsia e transtornos psicóticos apresentam um maior comprometimento clínico geral o que interfere diretamente no seu comprometimento funcional e na gravidade do impacto. Os pacientes com epilepsias mais graves e algum tipo de insulto ao SNC parecem ser mais vulneráveis ao desenvolvimento de transtornos psicóticos em comparação aos pacientes com formas menos graves de epilepsia / The association between epilepsy and psychotic disorders has been well documented in literature. Although this association is well-known, few studies regarding psychosis and epilepsy investigated the clinical characteristics of these patients and its impact on psychosocial function, suicide and suicide attempts, homicide attempts and cognitive deficits. The aim of this chart review was to compare the clinical impact and the psychosocial function between patients with epilepsy and psychotic disorders and patients with epilepsy and other psychiatric disorders. We also compared the clinical characteristics and psychosocial function between patients with postictal psychosis and interictal psychosis. We reviewed 143 charts, divided in two groups: 82 charts of patients with epilepsy and psychotic disorders and 61 charts of patients with epilepsy and other psychiatric disorders. In the group of patients with epilepsy and psychosis, 53 had a diagnosis of interictal psychosis and 17 of postictal psychosis. Patients with psychotic disorders had fewer years of education, more family history of psychotic disorders and higher number of homicide attempts, status epilepticus, psychiatric admissions and history of central nervous system insults. They also presented more impact on cognitive, vocational and interpersonal scales. Epilepsy was considered a major cause to the development of psychosis. Regarding the differences between patients with interictal and postictal psychosis, the only difference found was that the patients with interictal psychosis presented more family history of psychosis. Also, in both groups epilepsy was considered a major cause to the development of psychosis. Patients with psychotic disorders had a more severe clinical impairment in comparison with patients with other psychiatric disorders, which may have interfered in psychosocial functioning and severity of impact. Patients with central nervous system\'s insults and severe epilepsy may be likely more prone to psychosis\'s development than other patients with less severe forms of epilepsy

Antecedentes: A obesidade e os transtornos mentais são grandes desafios da medicina. A obesidade tornou-se uma epidemia mundial e os transtornos mentais têm sido cada vez mais diagnosticados. Estudos recentes mostraram frequências elevadas de transtornos mentais em pacientes candidatos à cirurgia bariátrica. Este cenário sugeriu que os transtornos psiquiátricos podem ser persistentes, coocorrentes e que haja uma possível formação de agrupamentos de sintomas psicopatológicos entre esses pacientes. Objetivo: O objetivo deste trabalho foi: 1) investigar a persistência e a coocorrência dos transtornos psiquiátricos em pacientes com obesidade pré-cirúrgicos; 2) identificar subgrupos psicopatológicos, clinicamente distintos e diferenciados por gêneros, em uma amostra de pacientes com obesidade candidatos à cirurgia bariátrica. Método: O estudo teve como base a dissertação \"Frequência de transtornos mentais entre pacientes obesos candidatos a cirurgia bariátrica, por meio de entrevista clínica estruturada para transtornos do DSM (SCID-I/P)\", apresentada ao programa de pós-graduação da Faculdade de Medicina da Universidade de São Paulo. Estudo observacional transversal em pacientes com obesidade grau III que aguardavam a cirurgia bariátrica, no Hospital das Clínicas de São Paulo. Os sujeitos foram recrutados consecutivamente da lista de espera do Ambulatório de Cirurgia Bariátrica - HC-FMUSP e submetidos à entrevista semiestruturada para diagnóstico psiquiátrico: Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID I/P). O tamanho da amostra foi de 393 pacientes; composta por 79,1% de mulheres; média de idade 43 anos e média de IMC: 47,8 kg/m². O curso dos transtornos psiquiátricos foi analisado pela persistência, por meio de razão de prevalência (RP): transtornos atuais/transtornos ao longo da vida (1M/LT); para as comorbidades utilizou-se a análise de correlação tetracórica. Os possíveis agrupamentos psicopatológicos, foram detectados pelo método da análise de classes latentes, baseado na ocorrência de transtornos mentais ao longo da vida, diferenciados por gênero. Análise de regressão logística mostrou a influência de fatores sociodemográficos na formação das classes psicopatológicas. Resultados: A maior parte da amostra apresentou dois ou mais transtornos psiquiátricos concomitantes ao longo da vida. Os transtornos de ansiedade foram as condições mais persistentes (a maior razão de prevalência entre transtornos atuais e/ou ao longo da vida) e correlacionaram-se significativamente com transtornos bipolares, depressivos e alimentares. Os transtornos bipolares foram os mais coocorrentes, associaram-se ao uso de substâncias, transtornos alimentares e de ansiedade. Em relação à análise de classe latente, para ambos os sexos, foram detectados três agrupamentos psicopatológicos. Entre as mulheres, as classes latentes foram: (1) \"oligossintomático\": 42% das pacientes apresentaram baixa probabilidade de transtornos psiquiátricos; (2) \"bipolar com comorbidades\", em 33%; e (3) \"ansiedade/depressão\", com 25%. Entre os homens: (1) \"bipolar com comorbidades\" foi encontrado em 47% dos pacientes; (2) \"oligossintomático\", com 40%; e (3) \"ansiedade/depressão\", com 13%. Para ambos os sexos, a probabilidade de apresentar transtornos alimentares foi maior nas classes \"bipolar com comorbidades\" e \"ansiedade/depressão\". Transtornos por uso de substâncias foram proeminentes entre os homens \"bipolares\". Em comparação com a classe \"oligossintomática\", a probabilidade de maior IMC foi observada entre os homens \"bipolares\" e pior desempenho no trabalho entre os homens com \"ansiedade/depressão\". Conclusões: Transtornos psiquiátricos são condições frequentes e duradouras entre pacientes à procura de cirurgia bariátrica. Transtornos de ansiedade, humor e alimentares são características persistentes e concomitantes em pacientes em busca de tratamento para obesidade. Homens e mulheres com obesidade grave, pré-cirúrgicos foram distribuídos em três perfis de comorbidades e revelaram padrões psicopatológicos análogos. A classe \"bipolar com comorbidades\" apresentou coocorrência com transtornos alimentares e uso de substâncias. Esses agrupamentos naturais de transtornos psiquiátricos entre pacientes bariátricos sugerem abordagens terapêuticas específicas e diferenciadas por gênero durante todo o percurso do procedimento cirúrgico / Background: Obesity and mental disorders have become major challenges to medicine. Obesity gained worldwide epidemic proportions and the mental disorder has been increasingly diagnosed. Recent study indicated high frequency of mental disorders in patients candidates to bariatric surgery, this panorama suggests that psychiatric disorders can be persistent and co-occurring. These conditions indicates the possibility of subgroups psychopathological between obese patients seeking to bariatric surgery. Objective: The objective of this study is: 1) to investigate the persistence and cooccurrence of psychiatric disorders and, 2) identify clinically distinct psychopathological subgroups among a sample of obese patients candidates for bariatric surgery. Method: The study is based on a study \"Frequency of mental disorders among obese candidates for bariatric surgery, using a structured clinical interview for DSM Disorders (SCID-I/P)\" presented to the post-graduate program of the Department and Institute of Psychiatry - University of São Paulo. This is a cross-sectional observational study in patients with obesity level III, awaiting bariatric surgery at the Hospital das Clínicas de São Paulo. The subjects were submitted to semi-structured interview for psychiatric diagnosis: Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID). Were consecutively recruited from the waiting list of the Bariatric Surgery Clinic-HCFMUSP. The sample size was 393 patients 79.1% women; age mean 43 years and mean of BMI 47,8% kg/m². The persistence of group of disorders was defined by prevalence ratio (PR) to denote the one month-to-lifetime (1M/LT). The co-occurrence of psychiatric disorders was investigated by the tetracoric correlation analysis. The possible psychopathological profiles were detected by the method of latent class analysis, based on the occurrence of lifetime psychiatric disorders, differentiated by gender. Logistic regression analysis showed the influence of socio-demographic factors on the formation of psychopathological classes. Results: Most of the sample presented two or more co-occurrence lifetime psychiatric disorders. While mood and eating disorders were frequent conditions, anxiety disorders were the most persistent conditions (the highest one month-to-lifetime prevalence ratio) and were significantly correlated with bipolar, depressive and eating disorders. In relation the latent class analysis, for both genders, the 3-class psychopathological clustering was the best-fitting solution. Among women, the latent classes were: (1) \"oligosymptomatic\", where in 42% of patients showed low probability of psychiatric disorders; (2) \"bipolar with comorbidities\", in 33%; and (3) \"anxiety/depression\", in 25%. Among men, (1) \"bipolar with comorbidities\" was found in 47% of patients; (2) \"oligosymptomatic\", in 40%; and (3) \"anxiety/depression\", in 13%. For both genders, the likelihood of eating disorders was higher in both \"bipolar with comorbidities\" and anxiety/depression\" classes. Substance use disorders was prominent among \"bipolar\" men. In comparison with \"oligosymptomatic\" class, the likelihood of higher BMI was observed among \"bipolar\" men and poorer work attainment among men with \"anxiety/depression\". Conclusion: Psychiatric disorders are frequent and enduring conditions among patients looking for bariatric surgery. Comorbid anxiety, mood, and eating disorders are remarkable features in treatment-seeking patients with obesity. Three comorbidity profiles were detected in pre-surgical period, in men and women with severe obesity. The class of \"bipolar with comorbidities\" most likely presented comorbidity with eating and substance use disorder. This natural clustering of psychiatric disorders among bariatric patients suggests gender-related therapeutic approaches