ABSTRACT
BACKGROUND: Osteogenesis imperfecta (OI) is an inherited disorder, which causes brittle bones resulting in recurrent fractures. The associated poor mobility of children with OI increases susceptibility to obesity, and obesity further dramatically limits mobility and increases fracture risk. OBJECTIVES: The aim of this report is to describe outcomes of weight loss surgery (WLS) in 2 adolescents with severe obesity and OI. SETTING: Two University Hospitals (in the United Kingdom and in the United States). METHODS: Two cases of OI treated with WLS were identified. Pre- and postoperative anthropometric and biochemical data and clinical course were reviewed. RESULTS: In these 2 cases, preoperative Body Mass Index (BMI) values were 38 and 46 kg/m2. Following laparoscopic sleeve gastrectomy (LSG), BMI decreased by 55% and 60% by 26 and 24 months, respectively. There were no surgical complications, and both patients experienced improvement in their mobility and ability to perform activities of daily living. CONCLUSION: WLS effectively treated severe obesity in 2 OI patients and substantially improved mobility and quality of life, theoretically reducing fracture risk.
Subject(s)
Gastrectomy/psychology , Laparoscopy/psychology , Obesity, Morbid/surgery , Osteogenesis Imperfecta/psychology , Pediatric Obesity/surgery , Quality of Life , Activities of Daily Living , Adolescent , Bariatric Surgery/psychology , Body Mass Index , Female , Humans , Male , Obesity, Morbid/psychology , Pediatric Obesity/psychology , Postoperative Care , Treatment Outcome , Weight Reduction Programs/methodsABSTRACT
INTRODUCTION: Postpartum depression is a disabling psychological disorder that, if left untreated, may have negative consequences for the mother, her partner, and the child. Although women with postpartum depression often experience symptoms of anxiety as well as depression, this has been underresearched. As metacognitive therapy assumes that the underlying mechanisms for both anxiety and depression are the same, it is a potentially useful psychological treatment for postpartum depression. METHODS: A pilot study was carried out using a multiple-baseline single case series to examine the effects associated with metacognitive therapy in the treatment of depression. Six women with postpartum depression were assigned to no-treatment baselines of 3 to 6 weeks, followed by 8 to 12 sessions of metacognitive therapy. Follow-up with participants took place at 3 and 6 months posttreatment. RESULTS: All participants experienced clinically significant reductions in symptoms of depression and anxiety, with corresponding reductions in metacognitive beliefs consistent with the idea that this may be the mechanism by which change occurred. Furthermore, all scores fell within the normal range posttreatment, and effect sizes were large. Treatment gains were maintained at 3 and 6 months posttreatment by all participants. DISCUSSION: This pilot study suggests that metacognitive therapy may be an effective psychological treatment for postpartum depression.
