Associations between psychological test results and failure to proceed with bariatric surgery

作者：Marek Ryan J^*; Tarescavage Anthony M; Ben Porath Yossef S; Ashton Kathleen; Heinberg Leslie J; Rish Julie Merrell

来源：Surgery for Obesity and Related Diseases, 2017, 13(3): 507-513.

DOI：10.1016/j.soard.2016.09.007

• Obesity
• Bariatric
• Psychology
• Assessment
• Incremental validity
• Dropout

Background: The reasons why some patients who begin the presurgical process for bariatric surgery fail to complete the procedure are understudied. Previous research implies that psychological factors play a role.
Objectives: To examine whether scores from baseline psychological testing incrementally predict failure to proceed with bariatric surgery beyond demographic information in patients' medical charts and data derived from a clinical interview.
Setting: Cleveland Clinic Bariatric and Metabolic Institute.
Methods: The sample (n = 1160) was mainly female (72.41%), middle aged (mean age = 46.07 yr, SD = 11.70) and of Caucasian descent (65.76%). Hierarchical logistic regressions were conducted to test the incremental validity of baseline Minnesota Multiphasic Personality Inventory 2 Restructured Form scores after controlling for information gathered from the psychological interview and medical charts. Relative risk ratios were calculated to reflect the clinical utility of the results.
Results: In total, 27.16% of patients failed to proceed with bariatric surgery after I year or more after a recommendation for surgery from their psychological evaluations. Psychological test scores were substantially associated with failure to proceed with surgery and significantly accounted for up to 6% of additional variance after controlling for psychological interview variables and medical chart data. Elevated scores on Minnesota Multiphasic Personality Inventory-2 Restructured Form scales, such as anxiety and substance use, identify patients at up to 2.5 times greater risk for failing to proceed with bariatric surgery.
Conclusions: Objective psychological test data notably, scale scores assessing for substance abuse, anxiety, and demoralization add to information obtained from a clinical interview and medical records in identifying patients at risk for failing to proceed with bariatric surgery. (Surg Obes Relat Dis 2017;13:507-513.

• 出版日期2017-3