Temperamento emocional e afetivo em pacientes obesos tabagistas candidatos a cirurgia bariátrica

Abstract

Background: The prevalence of smoking habits in the morbidly obese is higher than in the general population. There is some evidence that smokers have different temperaments compared to non-smokers. Methods: We analyzed data on affective and emotional temperament assessed by the AFECTS scale in a cross-sectional survey of bariatric surgery candidates, 18-65 years old, with class II and III obesity, recruited and grouped in smokers, ex-smokers, and non-smokers. Results: No significant differences were detected in affective and emotional temperament with respect to smoking status among 420 bariatric surgery candidates (74.5% females, 92.9% Caucasian and mean BMI of 45.9±7.6 kg/m2), except in patients without current psychiatric diagnosis or psychiatric medication. In these cases, smokers had higher scores in anxious than ex-smokers (median 3[2-4] percentile; median 2[1-4] percentile; P=0.007) and non-smokers (median 3[2-4] percentile; median 2[1-4] percentile P=0.005), and lower scores in control than non-smokers (39,7±11,2; 44,1±9,8; P=0.032), while ex-smokers scored higher in hyperthymic than non-smokers (median 4[4-5] percentile; median 3[2-4] percentile P=0.012). When the groups were stratified for BMI of 35-45 kg/m², smokers had higher scores in euphoric than ex-smokers (median 3[2-5] percentile; median 2[1-3] percentile; P=0.034), while ex-smokers scored higher in dysphoric than non-smokers (median 3[2-4] percentile; median 2[1-4] percentile; P=0.042). Ex-smokers with BMI >50 kg/m² scored higher on coping (P=0.034) and control (P=0.029) than smokers when adjusted for age and sex. Dysphoric and euphoric temperaments was associated with light smokers (median 3[2-4] percentile; median 2[1-3] percentile; P=0,009; median 3[1-4] percentile; median 2[1-3] percentile; P=0.035). Conclusions: Smoking in bariatric surgery candidates was associated with lower control, higher anxiety and euphoric temperaments. Light smokers were associated with higher dysphoric and euphoric temperaments. Assessment of temperament in bariatric surgery candidates may help in decisions about smoking cessation treatment and prevention of smoking relapse after surgery.