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Minerva Psichiatrica 2006 March;47(1):89-94


language: Italian

Application of the biopsychosocial model for subgrouping obese treatment-seeking patients

Soreca I. 1, 2, Di Muro A. 1, Capano G. 1, Ciuoli C. 3, Pacini F. 3, Castrogiovanni P. 1

1 Unità di Psichiatria Dipartimento di Neuroscienze Università degli Studi di Siena, Siena 2 Dottorato in Scienze Neurologiche Applicate Università degli Studi di Siena, Siena 3 Unità Operativa Complessa di Endocrinologia Università degli Studi di Siena, Siena


Aim. Personality is an important background for cognitions, behaviours and individual lifestyle; it is, therefore, an important modulating factor in eating behaviour. Therapeutic interventions for the treatment of obesity include behavioural, educational and pharmacological strategies and it would be, therefore, useful to characterize patients in order to choose the most appropriate treatment. Aim of this study is to assess personality and temperament in a group of treatment seeking obese patients, according to Cloninger biopsychosocial model.
Methods. Sixty-one obese patients attending the ambulatory polyclinic were consecutively enrolled in the study group and compared with 28 healthy controls.
Results. Obese patients generally scored higher than controls on harm avoidance (HA) and lower in novelty seeking (NS) and self-directedness (SD). HA dimension represents insecurity, passivity, low exploratory behaviour and it is associated with the tendency to react with anxiety and depression in stressing situations. This temperamental trait has been frequently reported in patients with major depressive disorder and with bulimia and it seems to be related with serotoninergic system functioning. Temperamental characteristics found in obese subjects could represent a predisposing factor to depression or emotional problems in conflicting situations or relations, leading to inappropriate coping strategies, such as altered eating behaviour. According to Clonin-ger model, temperamental traits are strictly related to biological background; in this perspective, temperamental traits could be predictive of good pharmacological response to medications acting on noredrenergic and serotoninergic systems, as sibutramina and anti-sibutramine depressants.
Conclusion. Our study results confirm the model proposed here and open new perspectives on the psychobiological aspects of obesity. Owing to the small sample size and the few patients with binge-eating in our sample, however, no definitive conclusions can be drawn.

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