MENTAL FUNCTIONING IN A GROUP OF OBESE PATIENTS CANDIDATES FOR BARIATRIC TREATMENT: DEFENCE MECHANISMS AND ALEXITHYMIA

Abstract

Several studies confirm that obesity with comorbidity psychiatric disorders decreases the long-term success of surgical treatment. The prevalence of psychiatric disorders varies from 30% to 76% between the obese patients candidate for bariatric treatment (Hudson et al., 2007; Striegel-Moore et al., 2009). It goes without saying that it is essential to prearrange a correct assessment in patient with a severe obesity who are candidate for surgical treatment in order to ensure a long term successful treatment. The aim of the study is to outline some psychological factors that could promote and maintain conditions of severe obesity and to identify weak points in widely applied care pathway. This is a cross-sectional analysis of 39 consecutive treatment-seeking obese (body mass index > 35 kg/m2) patients (14 men, 25women) age 20-59 (age M= 39.3). All the study participants who filled in the DMI (Gleser & Ihilevic, 1969, 1986), a semi-projective test which aims to measure the relative intensity of usage of five major groups (TAO, PRO, PRN, TAS, REV) and in the TAS-20 (Bagby, Taylor, Parker, 1994) and in the TSIA (Taylor, Bagby, Caretti, & Schimmenti, 2014) to assess the alexithymia. 74% of the group (29 patients) got a symptomatic profile types. 79.3% of this is made up of REV and PRN/REV profiles. This defensive profile is related to a higher BMI, to an earlier onset obesity, to a poor effectiveness of medical treatments, to a high risk of post-surgical recurrence. At TAS-20, 36% of patients have a score > 51 (bordeline) and 19% a score >61 (alexithymic). At TSIA, 69.4% of patients are alexithymic. The results showed that mental functioning is mainly characterized by a tendency to deny the reality and overturn the representation of this and by alexithymic traits. This is a potential serious risk of bariatric treatment failure in these patients. Psychological treatment is necessary to reduce a higher risk of low adherence and drop out to treatment at the follow up.