Clinical and psychological correlates of health-related quality of life in obese patients

Health and Quality of Life Outcomes

Research

Giovanni Apolone¹  Maria L Petroni²  Carlo M Rotella³  Edoardo Mannucci⁴  Nicola Villanova⁵  Giulio Marchesini⁵ 

[1] Clinical Research Laboratory, "Mario Negri" Institute for Pharmacologic Research, Milan, Italy;Department of Metabolic Rehabilitation, San Giuseppe Hospital, Piancavallo, Italy;Endocrine Unit, Department of Clinical Pathophysiology, University of Florence, Italy;Geriatric Unit, Department of Critical Care, University of Florence, Italy;Unit of Metabolic Diseases & Clinical Dietetics, Department of Clinical Medicine, "Alma Mater Studiorum" University, Bologna, Italy;

关键词: Binge Eating;    Binge Eating Disorder;    Physical Domain;    Global Severity Index;    Somatic Disease;   

DOI  :  10.1186/1477-7525-8-90

 received in 2010-01-11, accepted in 2010-08-23,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundHealth-related quality of life (HRQL) is poor in obese subjects and is a relevant outcome in intervention studies. We aimed to determine factors associated with poor HRQL in obese patients seeking weight loss in medical units, outside specific research projects.MethodsHRQL, together with a number of demographic and clinical parameters, was studied with generic (SF-36, PGWB) and disease-specific (ORWELL-97) questionnaires in an unselected sample of 1,886 (1,494 women; 392 men) obese (BMI > 30 kg/m2) patients aged 20-65 years attending 25 medical units scattered throughout Italy. The clinics provide weight loss treatment using different programs. General psychopathology (SCL-90 questionnaire), the presence of binge eating (Binge Eating scale), previous weight cycling and somatic comorbidity (Charlson's index) were also determined. Scores on SF-36 and PGWB were compared with Italian population norms, and their association with putative determinants of HRQL after adjustment for confounders was assessed through logistic regression analysis.ResultsHRQL scores were significantly lower in women than in men. A greater impairment of quality of life was observed in relation to increasing BMI class, concurrent psychopathology, associated somatic diseases, binge eating, and weight cycling. In multivariate analysis, psychopathology (presence of previously-diagnosed mental disorders and/or elevated scores on SCL-90) was associated with lower HRQL scores on both psychosocial and somatic domains; somatic diseases and higher BMI, after adjustment for confounders, were associated with impairment of physical domains, while binge eating and weight cycling appeared to affect psychosocial domains only.ConclusionsPsychopathological disturbances are the most relevant factors associated with poor HRQL in obese patients, affecting not only psychosocial, but also physical domains, largely independent of the severity of obesity. Psychological/psychiatric interventions are essential for a comprehensive treatment of obesity, and to improve treatment outcome and to reduce the burden of disease.

【 授权许可】

Unknown   
© Mannucci et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.