Levent ATİK, Özge SARAÇLI, VİLDAN ÇAKIR KARDEŞ, Melek CENGİZ METE, NURAY ATASOY

Night eating behavior and psychiatric comorbidity in patients with morbid obesity

Objective: The relationship between night eating syndrome (NES) and obesity resembles a vicious circle. The pre-sence of NES facilitates the shift to obesity, whereas the NES is more common in obese individuals. In the literature,the frequency of NES is reported as 2-20% in individuals with morbid obesity. In addition to obesity, the presenceof NES was associated with higher depression scores and lower self-esteem. The aim of this study was to investi-gate the prevalence of NES and related factors in morbid obesity patients. Methods: In this study, 452 patientswho applied for psychiatric evaluation before the bariatric surgery were evaluated. The presence of psychiatricdisorder was assessed by a clinical interview conducted by a psychiatrist. Sociodemographic and clinical featuressuch as age, gender, education level, body mass index were also recorded. Beck Depression Inventory (BDI) andBeck Anxiety Inventory (BAI), Rosenberg Self Esteem Scale (RSES), and Night Eating Questionnaire (NEQ) wereadministered. Results: Fifty-nine (13%) of 452 morbid obesity patients were found to have NES. BDI, BAI, andRSES scores were significantly higher in the group with NES than without NES. In the group with NES, comparedwith non-NES; the rate of psychiatric disorder (44.1% and 26.2%, respectively) and depressive disorder (respect-tively, 25.4% and 13%) were significantly higher. The risk of developing NES in smokers increased by 3.05 fold;and a 1 unit increase in the BDI increases the risk of developing NES by 1.05 fold in the morbid obez sample. Dis-cussion: In our study, it was found that comorbidity of NES in morbid obesity patients increased the risk of psychi-atric disease, especially depression, and self-esteem was worse in these patients. The fact that smoking is thehighest predictor factor for the presence of NES is a finding that has been shown in other studies. The long-termfollow-up studies are needed to investigate changes in depression, NES and eating patterns after bariatric surgery.(Anatolian Journal of Psychiatry 2019; 20(6):605-612)

Morbid obezite hastalarında gece yeme davranışı ve psikiyatrik eş tanı

Amaç: Gece yeme sendromu (GYS) ile obezite ilişkisi bir kısır döngüyü andırmaktadır. GYS varlığı obeziteye kaymayı kolaylaştırırken, obez bireylerde GYS daha sık görülmektedir. Literatürde morbid obezitesi olan bireylerde GYS’nin oranı %2-20 arasında bildirilmiştir. Obeziteye ek olarak GYS’nin de olması depresyon puanlarının daha yüksek, benlik saygısının daha düşük olması ile ilişkili bulunmuştur. Bu çalışmada morbid obezite hastalarında GYS yaygınlığı ve ilişkili etkenlerin araştırılması amaçlanmıştır. Yöntem: Bu çalışmada Bülent Ecevit Üniversite Hasta- nesi Psikiyatri Polikliniği’ne, morbid obezite cerrahisi öncesi psikiyatrik değerlendirme için başvuran 452 hasta değerlendirilmiştir. Psikiyatrik bozukluk varlığı bir psikiyatri uzmanı tarafından yapılan klinik görüşme ile değerlendirildi. Sosyoekonomik ve klinik özellikler, yaş, cinsiyet, eğitim düzeyi, beden kitle indeksi kaydedildi. Beck Depres- yon ve Beck Anksiyete Ölçekleri, Rosenberg Benlik Saygısı Ölçeği ve Gece Yeme Anketini doldurmaları istendi. Bulgular: Dört yüz elli iki morbid obezite hastasının 59’unda (%13) GYS saptandı. GYS saptanan grupta BDÖ, BAÖ ve RBSÖ puanları GYS olmayan gruba göre anlamlı düzeyde daha yüksekti. GYS’li grupta, GYS olmayanlara göre psikiyatrik bozukluk (sırasıyla, %44.1 ve %26.2) ve depresyon (sırasıyla, %25.4 ve %13) oranı anlamlı olarak daha yüksekti. Morbid obezite örnekleminde sigara içmenin GYS görülme riskini 3.05 kat, BDÖ’deki 1 birimlik artışın GYS görülme riskini 1.05 kat artırdığı bulundu. Tartışma: Çalışmamızda morbid obezite hastalarında GYS eş tanı- sının psikiyatrik bozukluk, özellikle depresyon riskini artırdığı, bu hastalarda benlik saygısının daha kötü olduğu saptanmıştır. Sigaranın, GYS varlığı açısından en yüksek yordayıcı faktör bulunması başka çalışmalarda da göste- rilmiş olan bir bulgudur. Bariyatrik cerrahi sonrası depresyon, GYS ve yeme paterni ile ilgili değişikliklerin tarandığı uzun süreli izleme çalışmalarına gereksinim vardır. (Anadolu Psikiyatri Derg 2019; 20(6):605-612)

PDF

___

Stunkard AJ, Grace WJ, Wolff HG. The night- eating syndrome: A pattern of food intake among certain obese patients. Am J Med 1955; 19:78-86.

Rand CSW, Macgregor MD, Stunkard AJ. The night eating syndrome in the general population and among postoperative obesity surgery pa- tients. Int J Eat Disord 1997; 22:65-69. Fischer S, Meyer AH, Hermann E, Tuch A,Munsch S. Night eating syndrome in young a- dults: delineation from othereating disorders and clinical significance. Psychiatry Res 2012; 200:494-501.

Lundgren JD, Allison KC, Crow S, O'Reardon JP, Berg KC, Galbraith J, et al. Prevalence of the night eating syndrome in a psychiatric population. Am J Psychiatry 2006; 163:156-158

Lundgren JD, Rempfer MV, Brown CE, Goetz J, Hamera E. The prevalence of night eating syn-drome and binge eating disorder among over-weight and obese individuals with serious mental illness. Psychiatry Res 2010; 175:233-236.

Orhan FÖ, Özer UG, Özer A, Altunören Ö, Çelik M, Karaaslan MF. Night eating syndrome among patients with depression. Isr J Psychiatry Relat Sci 2011; 48:212-217.

Cengiz Y, Toker SG, Karamustafalıoğlu KO, Bakım B, Özçelik B. Prevalence of night eating syndrome and comorbidity with other psychiatric disorders in psychiatric outpatient population. Yeni Symposium 2011; 49:83-88.

Palmese LB, Ratliff JC, Reutenauer EL, Tonizzo KM, Grilo CM, Tek C. Prevalence of night eating in obese individuals with schizophrenia and schizoaffective disorder. Compr Psychiatry 2013; 54:276-281.

Saraçlı O, Atasoy N, Akdemir A, Güriz O, Konuk N, Sevinçer GM, Ankaralı H, Atik L. The preva-lence and clinical features of the night eating syndrome in psychiatric out-patient population. Compr Psychiatry 2014; 57:79-84.

Cerú-Björk C, Andersson I, Rössner S. Night eating and nocturnal eating-two different or similar syndromes among obese patients? Int J Obes Relat Metab Disord 2001; 25: 365-372.

Allison KC, Wadden TA, Sarwer DB, Fabricatore AN, Crerand C, Gibbons L, et al. Night eating syn-drome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Obesity 2006; 14(Suppl.2):77-82.

Marshall HM, Allison KC, O'Reardon JP, Birket-vedt G, Stunkard AJ. Night eating syndrome among nonobese persons. Int J Eat Disord 2004; 35:217-222.

Napolitano MA, Head S, Babyak MA, Blumenthal JA. Binge eating disorder and night eating syndrome: psychological and behavioral charac-teristics. Int J Eat Disord 2001; 30:193-203.

Gluck ME, Geliebter A, Satov T. Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients. Obes Res 2001; 9:264-267.

Baldofski S, Tigges W, Herbig B, Jurowich C, Kai-ser S, Stroh C, et al. Nonnormative eating be-havior and psychopathology in prebariatric pa-tients with binge-eating disorder and night eating syndrome. Surg Obes Relat Dis 2015; 11:621-626.

De Zwaan M, Marschollek M, Allison KC. The night eating syndrome (NES) in bariatric surgery patients. Eur Eat Disord Rev 2015; 23:426-434.

Eroğlu MZ, Sertçelik S, Tamam L. Eating disor-ders in bariatric surgery candidates admitted to Haydarpaşa Numune Training and Research Hos-pital. Anatolian J Psychiatry 2018; 19:355-361.

Lin HY, Huang CK, Tai CM, Lin HY, Kao YH, Tsai CC, et al. Psychiatric disorders of patients seeking obesity treatment. BMC Psychiatry 2013; 13:1.

Abiles V, Rodriguez-Ruiz S, Abiles J, Mellado C, Garcia A, Perez de la Cruz A, et al. Psychological characteristics of morbidly obese candidates for bariatric surgery. Obes Surg 2010; 20:161-167.

Beck AT, Ward CH, Mendelson M, Mock J, Er-baugh J. An Inventory form measuring depres-sion. Arch Gen Psychiatry 1961; 7:151-169.

Hisli N. Beck Depresyon Envanteri’nin üniversite öğrencileri için geçerliği güvenirliği. Psikoloji Derg 1989; 7:3-13.

Beck AT, Brown G, Epstein N, Steer RA. An inven-tory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56:893-897.

23. Cogn Psychother 1998; 12:163-172.

Allison KC, Lundgren JD, O'Reardon JP, Martino NS, Sarwer DB, Wadden TA, et al. The Night Eating Questionnaire (NEQ): Psychometric pro-perties of a measure of severity of the Night Eating Syndrome. Eat Behav 2008; 9:62-72.

Atasoy N, Saraçlı Ö, Konuk N, Ankaralı H, Güriz SO, Akdemir A, et al. The reliability and validity of Turkish Version of the Night Eating Questionnaire in psychiatric outpatient population. Anatolian Journal of Psychiatry 2014; 15:238-247.

Rosenberg, M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press, 1965.

Çuhadaroğlu, F. Adölesanlarda Benlik Saygısı. Yayımlanmamış Uzmanlık Tezi, Ankara, Hacet-tepe Üniversitesi Tıp Fakültesi, 1986.

Ferreira Pinto T, Carvalhedo de Bruin PF, Sales de Bruin VM, Ney Lemos F, Azevedo Lopes FH, Marcos Lopes P. Effects of bariatric surgery on night eating and depressive symptoms: a pro-spective study. Surg Obes Relat Dis 2017; 13:1057-1062.

Colles SL, Dixon JB, O'Brien PE. Night eating syndrome and nocturnal snacking: association with obesity, binge eating and psychological distress. Int J Obesity 2007; 31:1722-1730.

Mitchell JE, King WC, Courcoulas A, Dakin G, Elder K, Engel S, et al. Eating behavior and eating disorders in adults prior to bariatric surgery. Int J Eat Disord 2015; 48:215-222.

Dawes AJ, Maggard Gibbons M, Maher AR, Booth MJ, Miake Lye I, Beroes JM, et al. Mental health conditions among patients seeking and under-going bariatric surgery: a meta-analysis. JAMA 2016; 315:150-163.

Gade H, Rosenvinge JH, Hjelmesæth J, Friborg O. Psychological correlates to dysfunctional eating patterns among morbidly obese patients accepted for bariatric surgery. Obes Facts 2014; 7:111-119.

Scott KM, Bruffaerts R, Simon GE, Alonso J, Angermeyer M, de Girolamo G, et al. Obesity and mental disorders in the general population: results from the world mental health surveys. Int J Obes 2008; 32:192-200.

Mather AA, Cox BJ, Enns MW, Sareen J. Asso-ciations of obesity with psychiatric disorders and suicidal behaviors in a nationally representative sample. J Psychosom Res 2009; 66:277-285.

De Wit LM, Van Straten A, Lamers F, Cuijpers P, Penninx BW. Depressive and anxiety disorders: associated with losing or gaining weight over 2 years? Psychiatry Res 2015; 227:230-237.

De Zwaan M, Roerig D, Crosby R, Karaz S, Mitchell J. Night time eating: a descriptive study. Int J Eat Disord 2006; 39:224-32.

Küçükgöncü S, Beştepe E. Night eating syndrome in major depression and anxiety disorders. Archieves of Neuropsychiatry 2014; 1:368-375.

Lundgren JD, Williams KB, Heitmann BL. Noctur-nal eating predicts tooth loss among adults: re-sults from the Danish MONICA study. Eat Behav 2010; 11:170-174.