Psychiatric disorder comorbidity and association with eating disorders in bariatric surgery patients: A cross-sectional study using structured interview-based diagnosis.
OBJECTIVE
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.


METHODS
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.


RESULTS
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%).


CONCLUSIONS
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.
Rosenberger
Patricia H
PH
Department of Epidemiology & Public Health, Yale University School of Medicine, New Haven, CT 06519, USA.
Henderson
Kathryn E
KE
Grilo
Carlos M
CM
D000713:Anastomosis, Roux-en-Y; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D050110:Bariatric Surgery / Q000379:methods*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology*; D006306:Health Surveys; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology