Psychiatric Disorder Comorbidity and Association With Eating Disorders in Bariatric Surgery Patients: A Cross -Sectional Study Using Structured Interview-Based Diagnosis

Department of Epidemiology & Public Health, Yale University School of Medicine, New Haven, CT 06519, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 08/2006; 67(7):1080-5. DOI: 10.4088/JCP.v67n0710
Source: PubMed


This study examined the prevalence of DSM-IV Axis I psychiatric disorders in severely obese bariatric surgery candidates and explored whether eating disorders were associated with psychiatric comorbidity.
The Structured Clinical Interview for DSM-IV Axis I Disorders was administered to a study group of 174 consecutively evaluated bariatric surgery candidates. All evaluations were completed between September 2002 and November 2004.
Overall, 36.8% of the participants met criteria for at least one lifetime psychiatric disorder, with 24.1% meeting criteria for a current disorder. The most commonly observed lifetime psychiatric diagnoses were affective disorders (22.4%), anxiety disorders (15.5%), and eating disorders (13.8%). Participants with eating disorders were significantly more likely than those without eating disorders to meet criteria for psychiatric disorders overall (66.7% vs. 26.7%) and specifically for anxiety disorders (45.8% vs. 10.7%).
Psychiatric disorders are not uncommon among severely obese patients who present for bariatric surgery. The observed prevalence rates based on structured diagnostic interviews are lower than previously reported based on questionnaire, clinical, and chart review methods but are similar to those reported for nationally representative samples. Among bariatric surgery candidates, the presence of eating disorders is associated with higher rates of other psychiatric disorders. The findings highlight the importance of systematic diagnostic assessment using a structured diagnostic interview for determining the full spectrum of Axis I disorders.

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    • "They found high prevalence rates of lifetime psychiatric disorders (66.3%) in these patients, even before surgery; 37.8% of patients had at least one psychiatric disorder. Rosenburger et al. [24] in the US and Muhlhans et al. [12] in Germany also found that patients had a high prevalence of psychiatric disorders before bariatric surgery (36.8%, and 72.6%, respectively). Our prevalence of any psychiatric disorder (54.1%) in the surgical group was lower than that of Kalarchian and Muhlhans, but higher than that of Rosenberger. "
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    ABSTRACT: Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.
    BMC Psychiatry 01/2013; 13(1):1. DOI:10.1186/1471-244X-13-1 · 2.21 Impact Factor
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    • "ORCP-337; No. of Pages 15 xxx.e4 C.L. Wimmelmann et al. conditions has been found in patients with binge eating disorder (BED) [40] [41] and especially in patients with the most severe obesity [33] [42]. "
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    ABSTRACT: Background Morbid obesity is the fastest growing BMI group in the U.S. and the prevalence of morbid obesity worldwide has never been higher. Bariatric surgery is the most effective treatment for severe forms of obesity especially with regard to a sustained long-term weight loss. Psychological factors are thought to play an important role for maintaining the surgical weight loss. However, results from prior research examining preoperative psychological predictors of weight loss outcome are inconsistent. The aim of this article was to review more recent literature on psychological predictors of surgical weight loss. Methods We searched PubMed, PsycInfo and Web of Science, for original prospective studies with a sample size >30 and at least one year follow-up, using a combination of search terms such as ‘bariatric surgery’, ‘morbid obesity’, ‘psychological predictors’, and ‘weight loss’. Only studies published after 2003 were included. Results 19 eligible studies were identified. Psychological predictors of surgical weight loss investigated in the reviewed studies include cognitive function, personality, psychiatric disorder, and eating behaviour. Conclusion In general, recent research remains inconsistent, but the findings suggest that pre-surgical cognitive function, personality, mental health, composite psychological variables and binge eating may predict post-surgical weight loss to the extent that these factors influence post-operative eating behaviour.
    Obesity Research & Clinical Practice 01/2013; 8(4). DOI:10.1016/j.orcp.2013.09.003 · 1.18 Impact Factor
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    • "Patients with obesity have increased prevalence of psychiatric disorders compared to the general population [9-11]. In obese patients waiting for bariatric surgery, prevalence rates of life time psychiatric disorders vary from 37% to 73% and prevalence rates of current psychiatric disorders vary from 20% to 56% [9,10,12,13]. Comorbid psychiatric disorders generally aggravate symptoms and adversely affect treatment outcome in various somatic disorders like diabetes, pulmonary diseases and heart diseases [14-16]. Further, personality appears to have substantial influence on health behaviour [17,18]. "
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    ABSTRACT: Preoperative mental health seems to have useful predictive value for Health Related Quality of Life (HRQOL) after bariatric surgery. The aim of the present study was to assess pre- and postoperative psychiatric disorders and their associations with pre- and postoperative HRQOL. Data were assessed before (n = 127) and one year after surgery (n = 87). Psychiatric disorders were assessed by Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II). HRQOL was assessed by the Short Form 36 (SF-36) questionnaire. Significant improvements were found in HRQOL from preoperative assessment to follow-up one year after surgery. For the total study population, the degree of improvement was statistically significant (p values < .001) for seven of the eight SF-36 subscales from preoperative assessment to follow-up one year after surgery. Patients without psychiatric disorders had no impairments in postoperative HRQOL, and patients with psychiatric disorders that resolved after surgery had small impairments on two of the eight SF-36 subscales compared to the population norm (all effect sizes < .5) at follow-up one year after surgery. Patients with psychiatric disorders that persisted after surgery had impaired HRQOL at follow-up one year after surgery compared to the population norm, with effect sizes for the differences from moderate to large (all effect sizes ≥ .6). This study reports the novel finding that patients without postoperative psychiatric disorders achieved a HRQOL comparable to the general population one year after bariatric surgery; while patients with postoperative psychiatric disorders did not reach the HRQOL level of the general population. Our results support monitoring patients with psychiatric disorders persisting after surgery for suboptimal improvements in quality of life after bariatric surgery. The trial is registered at prior to patient inclusion (ProtocolID16280).
    Health and Quality of Life Outcomes 09/2011; 9(1):79. DOI:10.1186/1477-7525-9-79 · 2.12 Impact Factor
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