The predictive value of psychological assessment of candidates for gastric bypas: A medical chart review

• Nathalie Aubert ^[2] ; Vittorio Giusti ^[3] ; Isabelle Lyon-Pagès ^[2] ; Isabelle Carrard ^[2] ; Michel Suter ^[1] ; Friedrich Stiefel ^[2]
  1. [1] University Hospital of Lausanne

     University Hospital of Lausanne

     Lausana, Suiza

     
  2. [2] Service de Psychiatrie de Liaison, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne . Switzerland
  3. [3] Consultation d’Obésité et troubles du comportement alimentaire, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne. Switzerland

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 24, Nº 2, 2010, págs. 114-123
• Idioma: inglés
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  • Background and Objectives: Guidelines for bariatric surgery demand a psychological evaluation of applicants. The aim of this study was to evaluate if the presence of "psychological risk factors" predicts postoperative weight loss after gastric bypass. Methods: Medical records of obese women who underwent bariatric surgery between 2000 and 2004 were reviewed. Psychological assessment consisted of a one-hour semi-structured interview, summarized in a written report. Anthropometric assessment at baseline and 6,12,18 and 24 months after surgery included body weight, height and body mass index. Results: The mean BMI of included patients (N = 92) was 46.2 + 6,3 kg/m2 (range 38.4 - 69.7). Based on the psychological assessment, 27% (N = 25) of the patients were classified as having "psychological risk factors" and 28% (N = 26) were diagnosed with a psychiatric diagnosis, most often major depression. Two years after gastric bypass, 16% of patients with "psychological risk factors" achieved an excellent result (%EWL > 75) versus 39% of those without (p < 0.05). About 1 out of 4 patients was in postoperative psychiatric treatment, but only half of them were identified as having "psychological risk factors" at baseline. Weight loss of patients initiating a psychiatric treatment only after surgery was less than of patients who continued psychiatric treatment already initiated before surgery (55.7 + 14.8 versus 66.5 + 14.2 %EWL). Conclusions: A single semi-structured psychological interview may identify patients who are at risk for diminished postoperative weight loss; however, psychological assessment did not identify those patients who were in need of a psychiatric postoperative treatment.