Psychiatric Disorders Impeding Weight Loss in Obese Breast Cancer Survivors
| Autor: | William Hryniuk, Isabella Jenkins, Zora Djuric |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Cancer Research
medicine.medical_specialty Breast Neoplasms Overweight law.invention 03 medical and health sciences 0302 clinical medicine Prevalence of mental disorders Breast cancer Randomized controlled trial Weight loss law Behavior Therapy Weight Loss medicine Humans Bipolar disorder Obesity Survivors Psychiatry Exercise business.industry medicine.disease Diet Oncology Schizophrenia 030220 oncology & carcinogenesis Major depressive disorder Female medicine.symptom business Risk Reduction Behavior 030215 immunology |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 34(10) |
| ISSN: | 1527-7755 |
| Popis: | TO THE EDITOR: A recently reported, large randomized trial, Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY), used exercise and dietary counseling to reduce the weight of overweight and obese breast cancer survivors, with limited but significant results. Although individuals with “serious medical or psychological conditions” were excluded (14% of those initially screened), it is not clear what screening methods were used or the type of mental disorders that were excluded. In a small randomized trial (n5 48), we tested telecounseling as one component of a strategy to reduce weight in obese breast cancer survivors. Even though we excluded patients with bipolar disorder and schizophrenia, we found that, upon careful psychiatric screening, 49% of subjects participating in the trial had either major depression (23%) or minor psychiatric disorders (26%), according to Diagnostic and Statistical Manual of Mental Disorders IV criteria. A similar overall prevalence of mental disorders (41.6%) has been noted among patients with breast cancer in a recent, more comprehensive study. In our trial, participants with psychiatric disorders lost less weight, lost it more slowly, and regained virtually all of it despite continued intervention compared with those without psychiatric disorders. The finding was statistically (P 5 .019) and clinically significant. The weight loss at 30 months was as follows: 7.8% in participants with no disorder, 3.7% in those with a minor disorder, and 0.7% in those with a major depressive disorder. Despite the limited study size, these differences suggest that, among obese breast cancer survivors, there is a strong relationship between weight loss success and psychological well-being. This suggests future attempts at inducing weight loss in obese breast cancer survivors should take into account the mental health of study subjects, especially when evaluating results. The ENERGY trial may have included a substantial proportion of subjects with unrecognized psychiatric disorders, thus lowering the degree of weight loss attained. Assessment of the mental health of obese subjects in that trial, if feasible, might represent an opportunity to confirm our findings and give added impetus to the field. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|