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Previous issue date: 2013-09-19 / A Obesidade ? uma doen?a cr?nica de etiologia multifatorial que se caracteriza por excesso
de gordura corp?rea, cujo grau varia de acordo com o ?ndice de Massa Corporal
(IMC=m2
/kg). A obesidade grave ? caracterizada por IMC>40, frequentemente associada a
altera??es cl?nicas end?crino-metab?licas ou mec?nicas e transtornos psicol?gicos; o quadro
de Compuls?o Alimentar Peri?dica (CAP) tem alta incid?ncia nesta popula??o. A cirurgia
Bari?trica vem sendo o tratamento de escolha para a obesidade grave, por apresentar r?pido
emagrecimento e melhora nas condi??es cl?nicas. T?m-se verificado aumento de peso ap?s
dois anos de cirurgia em 20% a 30% dos casos. O objetivo geral desta pesquisa ? avaliar
caracter?sticas psicol?gicas e comportamentais entre obesos graves submetidos ? Cirurgia
Bari?trica do tipo Bypass G?strico h? pelo menos 24 meses. Foram investigados aspectos
espec?ficos como, (1) caracter?sticas do funcionamento personalidade e presen?a de
transtornos cl?nicos e de personalidade; (2) a incid?ncia de CAP e sua rela??o com perda de
peso; (3) a diferen?a entre os grupos em rela??o aos acompanhamentos p?s-cir?rgicos;
atividade f?sica, acompanhamento psicol?gico e nutricional. M?todo: 40 adultos (homens e
mulheres), com idades entre 23 a 60 anos, submetidos ? cirurgia bari?trica h? pelo menos 24
meses, na cidade de Natal-RN, foram divididos em dois grupos com n= 20, Grupo de Ganho,
com perda < 50% do peso excedente inicial, e o Grupo de Perda, com perda >50%. O
protocolo de pesquisa foi composto por question?rio biossociodemogr?fico, o m?todo de
Rorschach ? Sistema Compreensivo (SC); Invent?rio de Personalidade de Millon (MCMI-III);
e Escala de Compuls?o Alimentar Peri?dica (ECAP). Atrav?s do m?todo de Rorschach foram
evidenciadas diferen?as significativas entre os dois grupos, relacionadas aos tipos vivenciais
(EB), maior presen?a de EB Extratensivo no Grupo Ganho e Intratensivo no Grupo de Perda;
e ao descontrole na express?o dos afetos, com eleva??o de respostas de Cor Pura no Grupo
Ganho. Em rela??o ? popula??o normativa do SC, a amostra como um todo apresentou maior
tend?ncia a experienciar sofrimento ps?quico, auto percep??o denegrida, autocr?tica excessiva,
distor??es perceptivas, vulnerabilidade a desenvolver transtornos afetivos e eleva??o da
pontua??o na Constela??o de Suic?dio. O MCMI-III indicou maior incid?ncia de transtornos
cl?nicos e de personalidade no Grupo Ganho: Transtorno Depressivo e Esquizot?pico,
Ansiedade, Distimia, Depress?o Maior; Transtorno do Pensamento, Bipolar- Man?aco e
Transtornos de Estresse P?s-Traum?tico. Os resultados da ECAP indicaram diferen?a
significativa, com eleva??o de CAP no Grupo de Ganho como tamb?m, entre a gravidade de
CAP e presen?a de transtornos cl?nicos e de personalidade. Em rela??o aos acompanhamentos
foi encontrada diferen?a significativa no quesito atividade f?sica com mediana elevada no
Grupo de Perda. Os grupos ainda se diferenciaram em rela??o ao peso inicial e tempo p?scir?rgico,
indicando que quanto maior o peso inicial e tempo percorrido maior o aumento de
peso p?s-cir?rgico. Os resultados ainda revelam que os participantes com mais de 3 anos de
tempo cirurgia, apresentam eleva??o na presen?a de Transtornos Cl?nicos de Transtorno
Depressivo Maior; Transtorno Somatoforme; Distimia. Tais resultados corroboram
conclus?es de estudos sobre a rela??o entre CAP p?s-cir?rgico e novo ganho de peso, como
tamb?m acerca de maior incid?ncia de transtornos cl?nicos na popula??o obesa grave.
Conclui-se que o processo cir?rgico ? apenas uma faceta do tratamento da obesidade grave, e
que o acompanhamento p?s-cir?rgico deve receber maior aten??o e ocorrer em longo prazo
para a manuten??o n?o s? dos resultados cir?rgicos, como da melhoria da qualidade de vida
dos pacientes. / Obesity is a chronic disease that has multi-factorial aetiology, characterized by high
degree of body fat; the degree of obesity will vary according to the Body Mass Index
(BMI=m2
/kg). The severe degree of obesity is characterized by BMI>40 and it is
regularly associated to endocrine-metabolic or mechanic clinical alterations, and to
psychological disorders. Binge Eating (BE) results were overly high for this population.
The Bariatric Surgery has been the treatment chosen by those diagnosed with severe
obesity as this intervention provides prompt outcomes for loss of weight and clinical
improvement conditions. However, recent research has acquiesced that after two years
between 20% and 30% of people subject to this intervention gained weight. The main
objective of this research is to assess the psychological and behavioral characteristics of
those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in
the past 24 months. Specific aspects were investigated: (1) characteristics of different
personalities and diagnose of clinic and personality disorders; (2) BE and its relation
with loss of weight; (2) the difference between the groups regarding post-surgery care,
e.g. physical activity, psychological and dietician input. Method: 40 adults (women and
men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24
months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain
group displaying loss of < 50% of their initial surplus of weight, and the Loss
group displaying loss of >50%. The research protocol is made of a socio-demographic
questionnaire and 3 psychometric instruments: Rorschach ? Comprehensive System;
Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de
Compuls?o Alimentar Peri?dica (ECAP). Through Rorschach significant differences
between these groups were verified according to the kind of personality (EB) - more EB
Extratensivo in Gain group and Intratensivo in Loss group ? and the lack of control to
express affect, increasing the answer for Color Pure at Group I. Concerning the people
standardization, the sample as a whole tends to show psychic pain, denigrated selfperception,
high levels of self-criticism, distorted perceptions, vulnerability to develop
mood disorders and high scores regarding Suicide. MCMI-III results showed more
clinic and personality disorders in Group I: Depressive Disorder and Schizotypal,
Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic
and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant
differences, showing increased BE results in Gain group. There were found significant
differences between BE severity and the presence of clinic and personality disorders.
Concerning the post-surgery care, the observed differences are statistically significant
regarding physical activities with median-increased differences in Loss group. There is
a difference between the initial weight and the time post-surgery, indicating that the
higher the initial weight and the time after the surgery the higher the re-gain of weight
post-surgery. Finally, the results show that the participants with more than 3 years of
surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder;
Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of
weight as well as the proneness of clinic disorders in severe obesity people. That means
the results reinforce that the surgery process is a facet of the severe obesity treatment.
The post-surgery process needs to be the main focus of attention and have a long-term
input to sustain the care of the surgery results and the quality of life of the patients.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20000 |
| Date | 19 September 2013 |
| Creators | Venzon, Clarissa Nesi |
| Contributors | 34616055068, http://lattes.cnpq.br/1325459110950508, Torres, Gilson de Vasconcelos, 51326728415, http://lattes.cnpq.br/1944547152815226, Tavares, Marcelo da Silva Ara?jo, 22144161615, http://lattes.cnpq.br/6310422468528920, Alchieri, Jo?o Carlos |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM PSICOLOGIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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