Erfassung der Psychopathologie von Essstörungen bei adipösen Patienten vor Magenbandoperation: Interview oder Selbstbeurteilungsverfahren?

Zusammenfassung

In dieser Studie wurden zwei Methoden zur Erfassung essstörungsspezifischer Psychopathologie bei adipösen Patienten vor einer Magenbandoperation verglichen. Insgesamt 93 Patienten mit Adipositas Grad II und III wurden mittels der deutschsprachigen Versionen des Eating Disorder Examination (EDE) und dem Eating Disorder Examination-Questionnaire (EDE-Q) untersucht. Die Instrumente zeigten bezüglich der Subskalen gezügeltes Essen (Restraint), essensbezogene Sorgen (Eating Concerns), Figursorgen (Shape Concerns) und Gewichtssorgen (Weight Concerns), signifikante positive Korrelationen, wobei der Fragebogen gleichzeitig signifikant höhere Punktwerte erzielte. Die Häufigkeiten objektiver Essanfälle zeigten ebenfalls eine signifikante positive Korrelation jedoch mit geringem Korrelationskoeffizienten; es lag kein signifikanter Unterschied vor. Wurde ein Näherungskriterium zur Diagnose der Binge-Eating-Störung gewählt (Übereinstimmung von mindestens zwei objektiven Essanfällen pro Woche über 28 Tage), so zeigte sich eine moderate Übereinstimmung zwischen EDE und EDE-Q. Der EDE-Q scheint für die präoperative Erfassung essstörungsspezifischer Psychopathologie (Subskalen) bei Magenbandpatienten angemessen. Zur Erfassung objektiver Essanfälle ist der Fragebogen als alleiniges Instrument jedoch nur bedingt geeignet.

Abstract

The objective was to compare two methods for assessing eating disorder psychopathology in pre-gastric banding surgery patients. 93 morbidly obese patients were assessed with the German versions of the Eating Disorder Examination (EDE) and the Eating Disorder Examination-Questionnaire (EDE-Q). The EDE and the EDE-Q were significantly correlated on the restraint, eating concern, shape concern and weight concern subscales, although the questionnaire scores were significantly higher. Frequencies of objective bulimic episodes were slightly but significantly correlated and the difference between EDE and EDE-Q was not significant. When participants were classified as binge eaters based on a cut-off of two binges per week on average in the last 28 days, the concordance between EDE and EDE-Q was moderate. The EDE-Q seems well-suited in assessing eating disorder psychopathology in obese pre-gastric banding patients. Yet, for the assessment of binge eating episodes the use of the questionnaire alone can not be recommended.

Essstörung - EDE - EDE-Q - Subskalen - Magenband

eating disorder - EDE - EDE-Q - subscales - gastric banding

Literatur

• 1 World Health Organization .Obesity: Preventing and managing the global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Geneva; WHO 2000
• 2 Mensink G BM, Lampert T EB. Übergewicht und Adipositas in Deutschland 1984 - 2003.  Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2005;  48 1348-1356
• 3 Statistisches Bundesamt Deutschland .Ergebnisse der Mikrozensus-Befragung im Mai 2003. Mikrozensus. Abrufbar unter: http://www.destatis.de/allg/d/impr/d_impr.htm [20.9.2005]
• 4 Flegal K M, Carroll M D, Ogden C L, Johnson C L. Prevalence and trends in obesity among US adults, 1999 - 2000.  JAMA. 2002;  288 1723-1727
• 5 Ogden C L, Carroll M D, Curtin L R. et al . Prevalence of overweight and obesity in the United States, 1999 - 2004.  JAMA. 2006;  295 1549-1555
• 6 Bergmann K E, Mensink G BM. Körpermaße und Übergewicht.  Gesundheitswesen. 1999;  61 115-120
• 7 Buchwald H, Williams S E. Bariatric surgery worldwide 2003.  Obes Surg. 2004;  14 1157-1164
• 8 Hout G C van, Oudheusden I van, Heck G L van. Psychological profile of the morbidly obese.  Obes Surg. 2004;  14 579-588
• 9 American Psychiatric Association .Diagnostic and statistical manual of mental disorders, 4^th ed. Washington, DC; American Psychiatric Press 1994
• 10 Zwaan M de, Mitchell J E, Howell L M. et al . Characteristics of morbidly obese patients before gastric bypass surgery.  Compr Psychiatry. 2003;  44 428-434
• 11 Busetto L, Valente P, Pisent C. et al . Eating pattern in the first year following adjustable silicone gastric banding (ASGB) for morbid obesity.  Int J Obes Relat Metab Disord. 1996;  20 539-546
• 12 Dymek M P, Grange D le, Neven K, Alverdy J. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report.  Obes Surg. 2001;  11 32-39
• 13 Hsu L K, Betancourt S, Sullivan S P. Eating disturbances before and after vertical banded gastroplasty: a pilot study.  Int J Eat Disord. 1996;  19 23-34
• 14 Hsu L K, Sullivan S P, Benotti P N. Eating disturbances and outcome of gastric bypass surgery: a pilot study.  Int J Eat Disord. 1997;  21 385-390
• 15 Kalarchian M A, Marcus M D, Wilson G T. et al . Binge eating among gastric bypass patients at long-term follow-up.  Obes Surg. 2002;  12 270-275
• 16 Mitchell J E, Lancaster K L, Burgard M A. et al . Long-term follow-up of patients' status after gastric bypass.  Obes Surg. 2001;  11 464-468
• 17 Pekkarinen T, Koskela K, Huikuri K, Mustajoki P. Long-term Results of Gastroplasty for Morbid Obesity: Binge-Eating as a Predictor of Poor Outcome.  Obes Surg. 1994;  4 248-255
• 18 Fairburn C G, Cooper P J. The Eating Disorder Examination (12^th ed). In: Fairburn CG, Wilson GT (eds) Binge eating. Nature, assessment, and treatment. New York; Guilford Press 1993: 317-360
• 19 Greeno C G, Marcus M D, Wing R R. Diagnosis of binge eating disorder: discrepancies between a questionnaire and clinical interview.  Int J Eat Disord. 1995;  17 153-160
• 20 Grilo C M, Masheb R M, Lozano-Blanco C, Barry D T. Reliability of the Eating Disorder Examination in patients with binge eating disorder.  Int J Eat Disord. 2004;  35 80-85
• 21 Reas D L, Grilo C M, Masheb R M. Reliability of the Eating Disorder Examination-Questionnaire in patients with binge eating disorder.  Behav Res Ther. 2006;  44 43-51
• 22 Hilbert A, Tuschen-Caffier B, Ohms M. Eating Disorder Examination: Deutschsprachige Version des strukturierten Essstörungsinterviews Eating Disorder Examination: Validation of a German version.  Diagnostica. 2004;  50 98-106
• 23 Hilbert A, Tuschen-Caffier B, Karwautz A. et al .Eating Disorder Examination - Questionnaire: Evaluation der deutschsprachigen Übersetzung. Diagnostica 2006, in press
• 24 Binford R B, Grange D Le, Jellar C C. Eating Disorders Examination versus Eating Disorders Examination-Questionnaire in adolescents with full and partial-syndrome bulimia nervosa and anorexia nervosa.  Int J Eat Disord. 2005;  37 44-49
• 25 Carter J C, Aime A A, Mills J S. Assessment of bulimia nervosa: a comparison of interview and self-report questionnaire methods.  Int J Eat Disord. 2001;  30 187-192
• 26 Grilo C M, Masheb R M, Wilson G T. Different methods for assessing the features of eating disorders in patients with binge eating disorder: a replication.  Obes Res. 2001;  9 418-422
• 27 Grilo C M, Masheb R M, Wilson G T. A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder.  J Consult Clin Psychol. 2001;  69 317-322
• 28 Passi V A, Bryson S W, Lock J. Assessment of eating disorders in adolescents with anorexia nervosa: self-report questionnaire versus interview.  Int J Eat Disord. 2003;  33 45-54
• 29 Wilfley D E, Schwartz M B, Spurrell E B, Fairburn C G. Assessing the specific psychopathology of binge eating disorder patients: interview or self-report?.  Behav Res Ther. 1997;  35 1151-1159
• 30 Wolk S L, Loeb K L, Walsh B T. Assessment of patients with anorexia nervosa: interview versus self-report.  Int J Eat Disord. 2005;  37 92-99
• 31 Decaluwe V, Braet C. Assessment of eating disorder psychopathology in obese children and adolescents: interview versus self-report questionnaire.  Behav Res Ther. 2004;  42 799-811
• 32 Fairburn C G, Beglin S J. Assessment of eating disorders: interview or self-report questionnaire?.  Int J Eat Disord. 1994;  16 363-370
• 33 Mond J M, Hay P J, Rodgers B. et al . Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples.  Behav Res Ther. 2004;  42 551-567
• 34 Black C M, Wilson G T. Assessment of eating disorders: interview versus questionnaire.  Int J Eat Disord. 1996;  20 43-50
• 35 Kalarchian M A, Wilson G T, Brolin R E, Bradley L. Assessment of eating disorders in bariatric surgery candidates: self-report questionnaire versus interview.  Int J Eat Disord. 2000;  28 465-469
• 36 Zwaan M de, Mitchell J E, Swan Kremeier L. et al . A comparison of different methods of assessing the features of eating disorders in post-gastric bypass patients: A pilot study.  European Eating Disorders Review. 2004;  12 380-386
• 37 Husemann B, Bröhl F, Herpertz S. et al .Evidenzbasierte Leitlinie: Chirurgische Therapie der extremen Adipositas. 2004. Abrufbar unter: www.adipositas-gesellschaft.de/Leitlinien/leitlinien.html [15.06.2006]
• 38 World Health Organization .The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostical guidelines. 1992
• 39 Fairburn C G, Cooper Z. Eating Disorder Examination (14^th ed). Universität Oxford; Unveröffentlichtes Manuskript 2001
• 40 Landis J R, Koch G G. The measurement of observer agreement for categorical data.  Biometrics. 1977;  33 159-174
• 41 Cohen J. Statistical power analysis for the behavioral sciences (2^nd ed). Hillsdale, NJ; Lawrence Erlbaum Associates 1988
• 42 Lienert G A, Raatz U. Testaufbau und Testanalyse. 6. Aufl. Weinheim; Psychologie-Verlags-Union 1998
• 43 Goldfein J A, Devlin M J, Kamenetz C. Eating Disorder Examination-Questionnaire with and without instruction to assess binge eating in patients with binge eating disorder.  Int J Eat Disord. 2005;  37 107-111