Using the presurgical psychological evaluation to predict 5-year weight loss outcomes in bariatric surgery patients

作者：Marek Ryan J^*; Ben Porath Yossef S; van Dulmen Manfred H M; Ashton Kathleen; Heinberg Leslie J

来源：Surgery for Obesity and Related Diseases, 2017, 13(3): 514-521.

DOI：10.1016/j.soard.2016.11.008

• Obesity
• Bariatric surgery
• Assessment
• Weight loss
• Outcome
• Psychology

Background: Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent.
Objectives: Examine associations between presurgical psychiatric diagnoses derived from a semi structured clinical interview and test scores from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes.
Setting: Cleveland Clinic Bariatric and Metabolic Institute
Methods: 446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients' mean presurgical BMI was 49.14 kg/m(2) [SD = 9.50 kg/m(2)]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling.
Conclusion: Preoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes. (Surg Obes Relat Dis 2017;13:514-521.

• 出版日期2017-3