Bjarte Stubhaug

Psychiatry, Psychosomatic Medicine

15.40

Publications

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    ABSTRACT: Objective: The present study examined prevalence of psychiatric disorders before and 1 year after weight loss surgery. Furthermore, we studied if level of pre-operative shame could be a maintaining factor for psychiatric disorders at 1-year follow-up. Method: One-hundred and twenty-seven patients (F/M: 94/33) with mean body mass index (BMI) ± standard deviation (s) =45.3±5.2 kg/m(2) and mean age 41.3±10.3 years participated in the study. Eighty-seven patients met for follow-up 1 year after surgery. Psychiatric disorders were assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.) and the Structured Clinical Interview (SCID-II). Levels of depression, anxiety and shame were assessed by the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Internalized Shame Scale (ISS). Results: Sixty-one patients (48%) at pre-operative assessment and 16 patients (18%) at 1-year follow-up had a comorbid psychiatric disorder. The strongest predictor of post-operative psychiatric disorder was pre-operative psychiatric disorder, odds ratio of 27.7 (95% CI for EXP (B) 3.2-239.8, P =0.003). Pre-operative level of shame (higher than 50-point ISS score) was also a significant predictor for post-operative psychiatric disorders, odds ratio of 9.1 (95% CI for EXP (B) 1.8-44.4, P =0.007). Conclusion: There was a significant reduction in prevalence of psychiatric disorders from pre-operative assessment to follow-up 1 year after surgery. Level of shame at pre-operative assessment was associated with maintenance of psychiatric problems. This finding is of clinical importance, since psychiatric disorders persisting after bariatric surgery have strong impact on the course of weight loss and quality of life.
    Nordic journal of psychiatry 05/2012; 67(2). DOI:10.3109/08039488.2012.684703 · 1.50 Impact Factor
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    ABSTRACT: To assess if attendance to a preoperative counseling program improved weight loss or adherence to treatment guidelines in patients who underwent bariatric surgery. One-hundred-forty-one patients were included in the study. Sixty-nine percent chose to participate in the counseling groups. They were randomized to a Treatment group and a Control group. Thirty-one percent chose not to participate in the counseling. However, they gave their consent to assessment before and after surgery (Reference group). One year after bariatric surgery, 88% had a weight loss of ≥ 50% EWL, 37% reported more than 30 min of physical activity daily, 74% had 5-7 meals daily, and 87% took recommended vitamins. There were no differences in weight loss, eating habits, or physical exercise between the Treatment group, the Control group and the Reference group one year after surgery. Preoperative group counseling did not increase treatment adherence to recommended life-style changes. In accordance with findings in the present study, it is not reasonable to offer a preoperative counseling program for all patients undergoing bariatric surgery. Further research should focus on developing and evaluating programs for postsurgical follow-up, and identifying patients that are in need for more comprehensive treatment programs.
    Patient Education and Counseling 10/2011; 87(3):336-42. DOI:10.1016/j.pec.2011.09.014 · 2.60 Impact Factor
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    ABSTRACT: Preoperative mental health seems to have useful predictive value for Health Related Quality of Life (HRQOL) after bariatric surgery. The aim of the present study was to assess pre- and postoperative psychiatric disorders and their associations with pre- and postoperative HRQOL. Data were assessed before (n = 127) and one year after surgery (n = 87). Psychiatric disorders were assessed by Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II). HRQOL was assessed by the Short Form 36 (SF-36) questionnaire. Significant improvements were found in HRQOL from preoperative assessment to follow-up one year after surgery. For the total study population, the degree of improvement was statistically significant (p values < .001) for seven of the eight SF-36 subscales from preoperative assessment to follow-up one year after surgery. Patients without psychiatric disorders had no impairments in postoperative HRQOL, and patients with psychiatric disorders that resolved after surgery had small impairments on two of the eight SF-36 subscales compared to the population norm (all effect sizes < .5) at follow-up one year after surgery. Patients with psychiatric disorders that persisted after surgery had impaired HRQOL at follow-up one year after surgery compared to the population norm, with effect sizes for the differences from moderate to large (all effect sizes ≥ .6). This study reports the novel finding that patients without postoperative psychiatric disorders achieved a HRQOL comparable to the general population one year after bariatric surgery; while patients with postoperative psychiatric disorders did not reach the HRQOL level of the general population. Our results support monitoring patients with psychiatric disorders persisting after surgery for suboptimal improvements in quality of life after bariatric surgery. The trial is registered at http://www.clinicaltrials.gov prior to patient inclusion (ProtocolID16280).
    Health and Quality of Life Outcomes 09/2011; 9:79. DOI:10.1186/1477-7525-9-79 · 2.10 Impact Factor
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    ABSTRACT: Psychological and behavioural factors seem to influence the results of bariatric surgery and the ability to achieve sustained weight loss and subjective wellbeing after the operation. Adequate pre- and postoperative psychological counselling are suggested to improve the results of surgery. However, some patients are reluctant to participate in pre- and postoperative counselling. The aim of the present study was to investigate the possible influence of psychiatric disorders on willingness to participate in group counselling in patients accepted for bariatric surgery. One hundred and forty-one patients referred to bariatric surgery (F/M: 103/38) with mean body mass index (BMI) of 45.2 kg/m2 (SD = 5.3) and mean age of 42.0 years (SD = 10.4) were interviewed with Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II) preoperatively. The overall prevalence of current psychiatric disorders was 49%. Thirty-one percent did not want to participate in counselling groups. Patients who were unwilling to participate in counselling groups had significantly higher prevalence of social phobia (32%/ 12%, p = 0.006) and avoidant personality disorder (27%/ 12%, p = 0.029) than patients who agreed to participate. Psychiatric disorders are prevalent among candidates for bariatric surgery. Social phobia and avoidant personality disorder seem to influence the willingness to participate in counselling groups. Individual counselling and/or web-based counselling might be recommended for bariatric surgery patients who are reluctant to participate in group counselling.
    Obesity Surgery 06/2011; 21(6):730-7. DOI:10.1007/s11695-010-0146-7 · 3.74 Impact Factor
  • European Psychiatry 12/2010; 25:819-819. DOI:10.1016/S0924-9338(10)70810-5 · 3.44 Impact Factor
  • Bjarte Stubhaug
    Tidsskrift for den Norske laegeforening 07/2009; 129(12):1209.
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    ABSTRACT: Single interventions in chronic fatigue syndrome have shown only limited effectiveness, with few studies of comprehensive treatment programmes. To examine the effect of a comprehensive cognitive-behavioural treatment (CCBT) programme compared with placebo-controlled mirtazapine medication in patients with chronic fatigue, and to study the effect of combined medication and CCBT. A three-armed randomised clinical trial of mirtazapine, placebo and a CCBT programme was conducted to investigate treatment effect in a patient group (n=72) with chronic fatigue referred to a specialist clinic. The CCBT programme was compared with mirtazapine or placebo therapy for 12 weeks, followed by 12 weeks treatment with a mixed crossover-combination design. Assessments were done at 12 weeks and 24 weeks. By 12 weeks the treatment effect was significantly better in the group initially receiving CCBT, as assessed with the Fatigue Scale (P=0.014) and the Clinical Global Impression Scale (P=0.001). By 24 weeks the treatment group initially receiving CCBT for 12 weeks followed by mirtazapine for 12 weeks showed significant improvement compared with the other treatment groups on the Fatigue Scale (P<0.001) and the Clinical Global Impression Scale (P=0.002). Secondary outcome measures showed overall improvement with no significant difference between treatment groups. Multimodal interventions may have positive treatment effects in chronic fatigue syndrome. Sequence of interventions seem to be of importance.
    The British Journal of Psychiatry 03/2008; 192(3):217-23. DOI:10.1192/bjp.bp.106.031815 · 7.34 Impact Factor
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    ABSTRACT: Patients (n=997) visiting general practitioners in an area in Western Norway completed a battery of questionnaires related to subjective health complaints and fatigue. An additional 78 patients were referred directly to the hospital for neurasthenia. After screening the questionnaires and interviews with a selected sample, a total of 73 patients were finally accepted as 'neurasthenia' patients satisfying the ICD-10 diagnosis. These patients were compared with the remaining 1002 patients. Patients with neurasthenia had more prevalent and more severe subjective health complaints, particularly pseudoneurological and musculoskeletal complaints than the reference population of patients. They reported low levels of instrumental coping and poorer physical fitness, in spite of a comparable level of self reported physical activity and exercise. Women were over-represented in this group. This overall higher score on subjective complaints from all organ systems is in accordance with the hypothesis of an overall and general sensitization to the afferent inputs from their psychophysiological systems.
    Psychoneuroendocrinology 12/2005; 30(10):1003-9. DOI:10.1016/j.psyneuen.2005.04.011 · 5.59 Impact Factor
  • Bjarte Stubhaug
    Tidsskrift for den Norske laegeforening 10/2005; 125(17):2378-9.

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