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Not yet recruitingNCT06556459PSICOBARUpdated Aug 16, 2024

Psychological and Psychopathological Characteristics of Patients With Obesity Candidates for Bariatric Surgery

An observational study in Obesity, sponsored by Fondazione Policlinico Universitario Agostino Gemelli IRCCS. Not yet recruiting at 1 site in Italy. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-08-16.

Sponsored by Fondazione Policlinico Universitario Agostino Gemelli IRCCS · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
1,000
Ages
18 Years to 65 Years
Sex
All
01

Study summary

Patients with obesity who are candidates for bariatric surgery may exhibit high rates of psychological symptoms, mostly anxiety and depression, and even full-blown mental disorders. The etiopathogenesis of this association has been variously investigated, and among the various factors, the presence of systemic inflammation, even if low-grade, seems to be an underlying mechanism for both conditions. These associations have been shown to have a significant impact from both a clinical perspective and regarding the outcomes of the surgery itself . Worse outcomes have been described in individuals with anxiety-depressive syndromes or mood disorders. However, additional impacts on treatment can also result from the presence of dysfunctional personality traits and early traumatic experiences (reported in about 50% of individuals with severe/pathological obesity), which, in turn, correlate with pathological eating behaviors in a high percentage of cases.

Studies conducted in various countries show that about 40% of all patients undergoing bariatric surgery have at least one psychiatric diagnosis, with depressive disorders, anxiety disorders, and eating disorders being the three most common diagnoses

Most studies on bariatric patients have focused on factors predisposing to severe obesity or predictive of surgical outcomes and post-surgery progress, but often lack a more precise psychological and psychopathological characterization of this patient population. Targeted studies with a longitudinal design that include long-term post-surgery follow-up are necessary to clarify the actual role of these factors as well as their interaction with other pathophysiological mechanisms involved in the clinical presentation and response to various treatment strategies. Identifying new therapeutic targets during the preoperative evaluation process could, in fact, contribute to improving clinical and post-surgical outcomes. Despite bariatric surgery demonstrating a positive short-term impact on weight-related comorbidities and functioning levels, particularly in social relationships, the emergence of unique and peculiar psychosocial problems and/or concerns in the postoperative follow-up has been reported. In a 10-year longitudinal study, a significant increase in mental health service access was observed following bariatric surgery, especially among those with a positive psychiatric history before the surgery.

Besides weight loss, surgical outcomes should include improvements in metabolic status and medical comorbidities, increased quality of life, and better psychosocial and behavioral functioning. Even in a patient with excellent postoperative weight loss, psychosocial problems such as disruptions in interpersonal relationships, body image dissatisfaction, substance use, or suicidal ideation may arise.

Therefore, this study aims to investigate the sociodemographic, clinical, personality, psychological, and psychopathological characteristics of patients with severe/pathological obesity requesting bariatric surgery through a baseline assessment and, if applicable, at six and twelve months post-surgery.

02

Conditions studied

  • Obesity

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03

In context

Obesity

6,296 studies on the registry are indexed under Obesity; 1,695 are open to participants now.

This study's planned enrollment of 1,000 is above the median of 135 across 1,283 observational studies indexed under Obesity.

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Lead sponsor

Fondazione Policlinico Universitario Agostino Gemelli IRCCS is the lead sponsor of 920 studies on the registry; 529 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Adults with diagnosis of grade II or grade III (or pathological) obesity based on body mass index values, respectively, of 35-40 and >40 kg/m² who access the Policlinico to apply for bariatric surgery.

Inclusion criteria

  • All sex;
  • Age ≥18 years
  • Diagnosis of grade II or grade III (or pathological) obesity based on body mass index values, respectively, of 35-40 and >40 kg/m²
  • Multidisciplinary evaluation aimed at indicating bariatric surgery interventions as per clinical practice
  • Provision of written informed consent to participate in the study

Exclusion criteria

Exclusion Criteria:

  • Age \<18 years
  • Diagnosis of neurological disorders associated with cognitive decline (such as to impair the execution of psychometric assessment)
  • Confirmed pregnancy, breastfeeding, or potential pregnancy with positive serological β- HCG
  • Refusal to sign the informed consent to participate in the study
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
1,000 participants (estimated)
Patient registry
No

Interventions

  • ProcedureBariatric Surgery

    The patient performs: * psychological clinical interview * psychodiagnostic examination * internal medical examination * blood tests * electrocardiogram * bariatric surgery * surgical visit

06

What researchers measure

Primary outcomes

  1. Evaluation of anxiety and depressive symptoms with Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), Beck's Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI Y).

    Evaluation of changes in anxiety and depressive symptoms from baseline to one year after bariatric surgery with Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), Beck's Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI Y). GAD - 7: 0 - 4: minimal 5 - 9: mild 10 - 14: moderate 15 - 21: severe PHQ - 9: 0 - 4: minimal 5 - 9: mild 10 - 14: moderate 15 - 19: moderately severe 20 - 27: severe BDI-II: \< 7: none 8 - 17: mild 18 - 24: moderate \>25: severe STAI-Y1/Y2: 20 - 37: none or minimal 38 - 44: moderate 45 - 80: severe

    Time frame: 1 year

  2. Interim evaluation of anxious and depressive symptoms with Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), Beck's Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI Y).

    Interim evaluation of anxiety and depressive symptoms at six months after bariatric surgery with Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), Beck's Depression Inventory (BDI-II) and State-Trait Anxiety Inventory (STAI Y). GAD - 7: 0 - 4: minimal 5 - 9: mild 10 - 14: moderate 15 - 21: severe PHQ - 9: 0 - 4: minimal 5 - 9: mild 10 - 14: moderate 15 - 19: moderately severe 20 - 27: severe BDI-II: \< 7: none 8 - 17: mild 18 - 24: moderate \>25: severe STAI-Y1/Y2: 20 - 37: none or minimal 38 - 44: moderate 45 - 80: severe

    Time frame: 6 months

Secondary outcomes

  1. Evaluation of changes in psychological and psychopathological state dimensions from baseline to one year after bariatric surgery.

    Evaluation of changes in other psychological and psychopathological state dimensions from baseline to one year after bariatric surgery with Short Form Health Survey - 36 (SF-36), Perceived Stress Scale (PSS), Eating Disorder Examination Questionnaire (EDE-Q 6), Binge Eating Scale (BES), Clinical Impairment Assessment Questionnaire (CIA 3.0), Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). SF-36: The score ranges from 0 (negative health) to 100 (positive health). PSS: 0-13: low stress 14-26: moderate stress 27-60: high perceived stress EDE-Q 6: \> 2,8: clinically significant BES: \<17: improbable 17-27: possible \>27: possible CIA 3.0: The resulting scores range from 0 to 48, where a higher score indicates a higher level of secondary psychosocial impairment. CORE-OM: \<0,6: healthy 0,6-1: low 1-1,5: mild 1,5-2: moderate 2-2,5: moderately severe \>2,5: severe

    Time frame: 1 year

  2. Interim evaluations of changes in other psychological and psychopathological state dimensions at six months after bariatric surgery.

    Interim evaluations after six months of changes in other psychological and psychopathological state dimensions as per clinical practice. It will be used Short Form Health Survey - 36 (SF-36), Perceived Stress Scale (PSS), Eating Disorder Examination Questionnaire (EDE-Q 6), Binge Eating Scale (BES), Clinical Impairment Assessment Questionnaire (CIA 3.0), Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM). SF-36: The score ranges from 0 (negative health) to 100 (positive health). PSS: 0-13: low stress 14-26: moderate stress 27-60: high perceived stress EDE-Q 6: \> 2,8: clinically significant BES: \<17: improbable 17-27: possible \>27: possible CIA 3.0: The resulting scores range from 0 to 48, where a higher score indicates a higher level of secondary psychosocial impairment. CORE-OM: \<0,6: healthy 0,6-1: low 1-1,5: mild 1,5-2: moderate 2-2,5: moderately severe \>2,5: severe

    Time frame: 6 months

  3. Evaluation of the variation in global functioning levels from baseline to six months after bariatric.

    Evaluation of the variation in global functioning levels from baseline at six months after bariatric surgery with Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS 11), Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaire (CTQ-SF). DERS: Higher scores suggest greater problems with emotion regulation BIS-11: 30-49: low 50-69: mild 70-89: severe 90-120: extremely severe CD-RISC: A higher score indicates a higher level of resilience CTQ-SF: This questionnaire measures five types of abuse. For each type of childhood trauma, the higher the score is, the greater the severity of abuse for that scale.

    Time frame: 6 months

  4. Evaluation of the variation in global functioning levels at one year after bariatric surgery.

    Evaluation of the variation in global functioning levels from baseline at one year after bariatric surgery with Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsiveness Scale (BIS 11), Connor-Davidson Resilience Scale (CD-RISC) and Childhood Trauma Questionnaire (CTQ-SF). DERS: Higher scores suggest greater problems with emotion regulation BIS-11: 30-49: low 50-69: mild 70-89: severe 90-120: extremely severe CD-RISC: A higher score indicates a higher level of resilience CTQ-SF: This questionnaire measures five types of abuse. For each type of childhood trauma, the higher the score is, the greater the severity of abuse for that scale.

    Time frame: one year

  5. Evaluation of the variation of the quality of life at six months after bariatric surgery with Short Form Health Survey - 36 (SF-36).

    Evaluation of the variation of the quality of life at six months after bariatric surgery with Short Form Health Survey - 36 (SF-36). SF-36: The score ranges from 0 (negative health) to 100 (positive health).

    Time frame: six months

  6. Evaluation of the variation of the quality from baseline to one year after bariatric surgery with Short Form Health Survey - 36 (SF-36).

    Evaluation of the variation of the quality from baseline to one year after bariatric surgery with Short Form Health Survey - 36 (SF-36). SF-36: The score ranges from 0 (negative health) to 100 (positive health).

    Time frame: 1 year

  7. Identification of correlation between psychological and psychopathological trait dimensions and metabolic and inflammatory correlates.

    Identification of correlation between psychological and psychopathological trait dimensions and metabolic and inflammatory correlates that predict response to bariatric surgery interventions. It will be measured the variation of the metabolic and inflammatory correlates from baseline to one year after bariatric surgery. It will be considered: complete blood count with leukocyte count; C-reactive Protein (PCR); Erythrocyte sedimentation rate (VES); fibrinogen; magnesium; calcium; phosphorus; parathyroid hormone (PTH); vitamin D; uric acid; carbohydrate and lipid profile (glucose, total and HDL cholesterol, triglycerides);

    Time frame: 1 year

07

Study locations

1 site
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 16, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06556459
Lead sponsor
Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Responsible party
Sponsor
First posted
Aug 16, 2024
Start date
Sep 1, 2024 (estimated)
Primary completion
Sep 1, 2026 (estimated)
Completion
Dec 31, 2026 (estimated)
Last update
Aug 16, 2024

Study contacts

Marco Raffaelli
Contact
marco.raffaelli@policlinicogemelli.it
+390630156194
Marco Raffaelli
principal investigator · Fondazione Policlinico Universitario A. Gemelli, IRCCS

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Jul 2024. You cannot join it, but the record below documents what was studied.

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