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Standardized Response Mean (SRM)

Figure 33.9 Treatment effects on health-related quality of life (HRQL) in surgical cases and controls after 4 years in the SOS intervention study. The surgical cases are grouped by magnitude of weight loss after 4 years. HRQL change scores from baseline to 4-year follow-up are transformed to standardized response means (SRM). SRM is calculated as the mean change score divided by the standard deviation of change (Katz etal. (49)).

TFEQ, Three-Factor Eating Questionnaire; RE, restrained eating; DI, disinhibition; HU, hunger. OP, Obesity-Related Psychosocial Problems.

SIP, Sickness Impact Profile; A, ambulation; HM, home management; RP, recreation and pastimes; SI, social interaction. GHRI, General Health Rating Index; CH, current health.

HAD, Hospital Anxiety and Depression scale; A, anxiety symptoms; D, depression symptoms. MACL, Mood Adjective Check List. SE, Self-esteem. QL, Overall quality of life

Standardized Response Mean (SRM)

Figure 33.9 Treatment effects on health-related quality of life (HRQL) in surgical cases and controls after 4 years in the SOS intervention study. The surgical cases are grouped by magnitude of weight loss after 4 years. HRQL change scores from baseline to 4-year follow-up are transformed to standardized response means (SRM). SRM is calculated as the mean change score divided by the standard deviation of change (Katz etal. (49)).

TFEQ, Three-Factor Eating Questionnaire; RE, restrained eating; DI, disinhibition; HU, hunger. OP, Obesity-Related Psychosocial Problems.

SIP, Sickness Impact Profile; A, ambulation; HM, home management; RP, recreation and pastimes; SI, social interaction. GHRI, General Health Rating Index; CH, current health.

HAD, Hospital Anxiety and Depression scale; A, anxiety symptoms; D, depression symptoms. MACL, Mood Adjective Check List. SE, Self-esteem. QL, Overall quality of life

Summary: How Improvements are Evaluated and Related to Weight Loss

Key to success: need for both condition-specific and generic measures, long-term follow-up, large samples, matched controls Poor quality of life is mostly reversible if weight loss is substantial

Obesity-specific measures most responsive to weight reduction

HRQL and Obesity V: Detecting Mood Disorders

Studies of the prevalence of psychopathology in obese persons have yielded inconsistent results (61). The reasons for this are probably related to dif ferences in study populations as well as assessment methods. Obese men and women in the SOS registry study showed significantly more self-assessed psychiatric morbidity than reference subjects and other patient groups (39), emphasizing the high distress level associated with severe obesity. Self-assessment measures are of potential use in clinical practice for detecting mood disorders. For example, the Hospital Anxiety and Depression scale (HAD; see Appendix) could be used in the assessment of HRQL to increase attention to mental health aspects. The instrument was designed to detect mood disorders, particularly in the somatically ill. Therefore, the HAD does not involve any somatic items frequently found in similar instruments assessing psychiatric morbidity, e.g. Beck's Depression Inventory (67). The latter measure includes questions about appetite loss and weight change, which may be accurate indicators of depression in normal

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