ASSOCIATION BETWEEN AFFECTIVE TEMPERAMENT AND MORBID OBESITY IN BARIATRIC SURGERY CANDIDATES: A CASE-CONTROL STUDY

MOUSFI, Alexandre Karam Joaquim; MAUER, Sivan; NASSIF, Paulo Afonso Nunes; SIGWALT, Marcos Fabiano; CUENCA, Ronaldo Mafia; TORRES, Orlando Jorge Martins

doi:10.1590/0102-67202025000015e1884

Brazil

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Original Article • ABCD, arq. bras. cir. dig. 38 • 2025 • https://doi.org/10.1590/0102-67202025000015e1884 linkcopy

ASSOCIATION BETWEEN AFFECTIVE TEMPERAMENT AND MORBID OBESITY IN BARIATRIC SURGERY CANDIDATES: A CASE-CONTROL STUDY

ASSOCIAÇÃO ENTRE TEMPERAMENTO AFETIVO E OBESIDADE MÓRBIDA EM CANDIDATOS À CIRURGIA BARIÁTRICA: UM ESTUDO CASO-CONTROLE

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND: Affective temperaments are part of the spectrum of mood disorders and comprise the concepts of hyperthymia, dysthymia and cyclothymia. Numerous studies have demonstrated a strong relationship between obesity and mood disorders.

AIMS: The objective of the present study was to evaluate the frequency of affective temperaments in morbidly obese individuals and controls and to establish a possible association between affective temperaments and morbid obesity.

METHODS: The study evaluated 106 cases (morbidly obese) and one hundred controls (non-obese). To assess affective temperaments, the Temperament Evaluation in Memphis Pisa and San Diego - Rio de Janeiro TEMPS-Rio de Janeiro scale was applied. Depressive symptoms were assessed using the Hamilton Depression Rating Scale, anxiety symptoms using the Hamilton Anxiety Rating Scale and manic symptoms using the Young Mania Rating Scale. For univariate and multivariate analysis, logistic regression models were adjusted.

RESULTS: The presence of at least one affective temperament was 74.5% in the morbidly obese group and 63% in the non-obese group. When comparing the two groups, the statistical analysis of the age subgroup of individuals aged 50 years or over showed an odds ratio of 2.56 (1.07-6.09) for hyperthymic temperament.

CONCLUSIONS: In the age group of 50 years or more, cases of morbid obesity are significantly more likely (2.56 times) to occur in individuals with a hyperthymic temperament. Among the three types of affective temperaments evaluated, only hyperthymia could be a risk factor for morbid obesity.

HEADINGS:
Temperament; Mood Disorders; Obesity, Morbid; Bariatric Surgery

Characteristic/Classification	Sample
Characteristic/Classification	Total (n=206)		Control (n=100)		Case (n=106)
Age (years) (mean±SD)	206	48.1±13.8	100	53.6±14.3	106	42.9±11.0
Age (years) (%)
18-49	109	52.9	36	36	73	68.9
50-84	97	47.1	64	64	33	31.1
Education level (years) (mean±SD)	206	9.9±3.7	100	9.7±4.0	106	10.1±3.3
Weight (kg) (mean±SD)	206	94.9±30.4	100	69.6±11	106	118.7±22.5
Height (m) (mean±SD)	206	1.63±0.09	100	1.64±0.1	106	1.63±0.09
BMI (kg/m²) (mean±SD)	206	35.6±10.7	100	26.0±2.9	106	44.7±6.6
Gender (%)
Female	152	73.8	69	69.0	83	78.3
Male	54	26.2	31	31.0	23	21.7
Marital status (%)
Married	104	50.5	49	49.0	55	51.9
Single	42	20.4	21	21.0	21	19.8
Stable union	23	11.2	6	6.0	17	16.0
Separated/Divorced	21	10.2	15	15.0	6	5.7
Widower	16	7.8	9	9.0%	7	6.6
Ethnicity (%)
White	145	70.4	75	75.0	70	66.0
Brown	38	18.4	18	18.0	20	18.9
African American	23	11.2	7	7.0	16	15.1

Scale/Classification	Group
Scale/Classification	Control (n=100) (%)		Case (n=106) (%)
TEMPS-A - Dysthymia
Negative (<75%)	93	93.0	96	90.6
Positive (=75%)	7	7.0	10	9.4
TEMPS-A - Cyclothymia
Negative (<75%)	79	79.0	83	78.3
Positive (=75%)	21	21.0	23	21.7
TEMPS-A - Hyperthymia
Negative (<75%)	52	52.0	41	38.7
Positive (=75%)	48	48.0	65	61.3
Hamilton Depression Rating Scale (HAM-D)
Normal	54	54.0	60	56.6
Mild depression	39	39.0	41	38.7
Moderate depression	5	5.0	4	3.8
Severe depression	2	2.0	1	0.9
Hamilton Anxiety Rating Scale (HAM-A)
Mild anxiety	89	89.0	98	92.5
Moderate anxiety	7	7.0	4	3.8
Severe anxiety	4	4.0	4	3.8
Young Mania Rating Scale
No mania	100	100	106	100

Variable/Classification	Group				p*	OR (IC95%)
	Control		Case
	n	%	n	%
Dysthymia
Negative (<75%)	34	94.4	66	90.4
Positive (=75%)	2	5.6	7	9.6	0.762	1.03 (0.85-1.25)
Cyclothymia
Negative (<75%)	26	72.2	53	72.6
Positive (=75%)	10	27.8	20	27.4	0.937	0.99 (0.86-1.15)
Hyperthymia
Negative (<75%)	14	38.9	29	39.7
Positive (=75%)	22	61.1	44	60.3	0.933	0.97 (0.43-2.19)

Variable/Classification	Group				p*	OR (IC95%)
	Control		Case
	n	%	n	%
Dysthymia
Negative (<75%)	59	92.2	30	90.9
Positive (=75%)	5	7.8	3	9.1	0.268	0.89 (0.72-1.1)
Cyclothymia
Negative (<75%)	53	82.8	30	90.9
Positive (=75%)	11	17.2	3	9.1	0.685	0.97 (0.81-1.2)
Hyperthymia
Negative (<75%)	38	59.4	12	36.4
Positive (=75%)	26	40.6	21	63.6	0.034	2.56 (1.07-6.1)

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[TFN1] SD: standard deviation; BMI: body mass index ; kg: kilogram.