Bariatric surgery improves female pelvic floor disorders.

OBJECTIVES: Obesity aggravates pelvic floor disorders in women. Weight loss improves these disorders. The purpose of this study was to assess the evolution of pelvic floor disorders in women who have undergone bariatric surgery. PATIENTS AND METHODS: A prospective single-center study was conducted from December 2012 to February 2014. The parameters studied were diabetes, BMI, excess weight loss, multiparity, mode of delivery and their relation to obesity and pelvic floor disorders. We evaluated anorectal and urethral sphincter disorders using the PFDI-20 questionnaire preoperatively, at 1 month and then every 6 months thereafter. RESULTS: One hundred and sixteen patients underwent bariatric surgery. Seventy questionnaires were completed preoperatively and postoperatively. Weight loss was significant with an excess weight loss of 57.1%. The mean body mass index (BMI) decreased from 44.5 ± 6.31 kg/m(2) (range: 35.0-63.23) to 31.83 ± 5.83 kg/m(2) (range: 20.9-49.6). The average length of follow-up was 11.3 ± 5.2 months (range: 5-25). The incidence of urinary symptoms improved after surgery (P=0.003), as did the UDI-6 score (Urogenital distress inventory) (P=0.009). There was no improvement in other symptoms such as prolapse and colorectal-anal dysfunction. CONCLUSION: The prevalence of pelvic floor disorders is high among obese women; in this study, colorectal disorders were present in 53% and urinary disorders in 71.5%. Bariatric surgery-induced weight loss led to improvement in urinary continence disorders when assessed over an average follow-up of 11 months.

Adult children of alcoholics in treatment programs for anxiety disorders and substance abuse.

Studies of the first-degree relatives of patients with alcoholism and anxiety disorders have identified a significant overlap of these disorders. Forty percent of the patients in an outpatient anxiety disorder program were adult children of alcoholics (ACOA), a proportion similar to that found in the substance abuse program. The ACOAs in both programs were younger, had higher co-dependency scores and were younger when they had their first psychiatric contact than the controls. The adult children of alcoholics who had anxiety disorders were more likely to be female and their alcoholic parents were less likely to have had psychiatric antecedents to alcoholism. Aside from substance abuse, similarities in sociodemographic variables and the impact of the parents' alcoholism were noted, reinforcing the hypothesis that vulnerabilities to anxiety disorders and alcoholism overlap.

The adult children of alcoholics in a psychiatric population.

The issues confronting adult children of alcoholics (ACOA) are well publicized but their empirical basis remains limited. The screening of 250 consecutive psychiatric admissions to a general hospital revealed a significant prevalence of ACOAs across diagnoses. Compared to the other patients, the ACOA group was younger but with no other socioeconomic difference. The diagnoses of substance abuse and phobic disorders were more frequent. The group was psychiatrically hospitalized at an earlier age. The impact of an ACOA status varied with the parental biological relation and gender, and with the premorbid antecedents of parental alcoholism.