Opšta psihopatologija i impulsivnost kao pokazatelji potencijalnog ishoda medicinske nutritivne terapije kod predgojazih i gojaznih žena
Sažetak
Apstrakt
Uvod/Cilj. Gojazost je hronično oboljenje sa značajnim nepovoljnim efektima na zdravlje, a broj gojaznih osoba u svetu dostigao je epidemijske razmere. Medicinska nutritivna terapija je terapija izbora, ali je njena uspešnost ograničena zbog značajnog procenta odustajanja, kao i ponovnog dobijanja na težini koje je prate. Cilj ove studije je bio da se proceni da li psihijatrijski i specifični psihološki faktori (impulsivnost) mogu biti pokazatelji pozitivnog ishoda lečenja. Metode. Studijom je bilo obuhvaćeno ukupno 84 predgojaznih i gojaznih žena životnog doba 20–40 godina, koje su bile motivisane za medicinsku nutritivnu terapiju. Sve ispitanice su prošle individualno savetovanje i dobile dnevni plan ishrane koji je podrazumevao kalorijsku restrikciju od 20% u odnosu na procenjene dnevne energetske potrebe. Na početku studije sprovedeno je antropometrijsko merenje i primenjene su Lista simptoma od 90 pitanja (90-item Symptom Check-list) i Baratova skala impulsivnosti (Barratt Impulsiveness scale (BIS-11)). Nakon šest meseci primene kalorijski restriktivnog načina ishrane ponovljena su antropometrijska merenja. Ispitanice su podeljene u dve grupe: 40 ispitanica (48%) koje su izgubile ≥ 10% od početne telesne mase (uspešne) i 44 ispitanice (52%) koje su izgubile < 10% od početne telesne mase (neuspešne). Rezultati. Nije bilo značajne razlike između grupa ispitanica u odnosu na demografske karakteristike (godine života, stepen obrazovanja, zaposlenost, bračni status) i antropometrijske parametre na početku studije, kao i na skor opšte psihopatologije i dimenzije simptoma. Statistički značajna razlika između uspešnih i neuspešnih predgojaznih/gojaznih ispitanica dobijena je za ukupni BIS-11 skor (p < 0.001) i za Faktor II (motorna impulsivnost) (p < 0.05). Zaključak. Ispitanice sa ponovljenim lošim odgovorom nisu se razlikovale po opštoj psihopatologiji od onih sa uspešnim odgovorom na nutritivnu terapju. Naši rezultati ukazuju na impulsivnost kao mogući pokazatelj ishoda lečenja. Ukupna impulsivnost i motorna impulsivnost kao indikator povremenog impulsivnog prejedanja bili su viši u grupi predgojazih/gojaznih ispitanica koje nisu postigle terapijski cilj. Psihoterapijski rad na impulsivnosti možda bi mogao doprineti boljem ishodu medicinske nutritivne terapije.
Reference
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