Abnormal temperament in obese patients

Objectives: Obesity has been considered as “an epidemic phenomenon”, showing a current prevalence of 10–35%. Therapeutic interventions include dietary programs, cognitive–behavioral therapy, appetite inhibiting drugs, surgical interventions such as gastric banding and physical exercise. Suggested pathogenic factors include among other things: Increased dietary energy intake and decreased energy expenditure, genetic susceptibility, as well as endocrinological and behavioral alterations. Recent research in psychiatry has suggested a positive relationship between obesity and mood disorders, especially for major depression and bipolar disorder. Other studies have revealed temperamental abnormalities, greater novelty seeking in obese patients, using the Temperament and Character Inventory of Cloninger. The aim of the present study was to identify differences in abnormal temperament in 101 obese and 100 control subjects.

Methods: Between May and November 2014 a total of 101obese patients were referred to our psychiatry clinic and were consecutively evaluated regarding suitability for surgical intervention. All patients were asked to complete the following self-rating battery: Temperament evaluation of Memphis, Pisa, Paris and San Diego Auto questionnaire (TEMPS-A). Statistical analyses were performed using the statistics software SPSS version 17.0 (Statistical package for the Social Sciences, version 17.0).

Results: No significant differences in sex, marital status and educational level were found. Sixteen of 101 (15.8%) in the obese group in comparison to twenty six of 100 (26%) in the control group were rated as showing at least one abnormal temperament. The two groups did not differ significantly regarding the mean number of abnormal temperaments (p=0.11). In total, 6 patients in the obese group were classified as abnormal in the depressive, 1 in the cyclothymic, 2 in the hyperthymic, 4 in the irritable and 8 in the anxious temperament. In the control group 18 patients exhibited a depressive, 2 a cyclothymic, 0 a hyperthymic, 6 an irritable and 9 an anxious temperament. The control group scored significantly higher in the depressive temperament (p=0.016). No significant differences were found in cyclothymic, hyperthymic, irritable and anxious temperaments between two groups.

Conclusion: A limitation of our study is that psychiatrically healthy individuals were selected as a control group. The lack of significant group differences in the cyclothymic, hyperthymic, irritable and anxious temperaments may have been due to these “hypernormal” individuals. This study represents the first use of TEMPS-A to evaluate abnormal temperaments in obese persons in Turkey. Our results need replication. However, the association of obesity with psychiatric diseases has been pointed by previous studies. Temperament subtypes have the potential to add an important predisposing factor for the development of this hard-to-treat disease.