title: Predictors of psychological symptoms in morbidly obese patients after gastric bypass surgery.
abstract: BACKGROUND
  Morbid obesity is associated with debilitating psychosocial consequences, such as depression, anxiety, and low self-esteem. One of the main goals of bariatric surgery should not only be reducing weight and counteracting co-morbid conditions, but also improving postoperative psychosocial functioning. The objective of our study was to determine the preoperative variables that could predict the psychological symptoms 6 and 12 months after surgery to improve the clinical outcome of morbidly obese patients undergoing bariatric surgery. The setting was a university hospital in Spain.
  
  
  METHODS
  The study group consisted of 60 morbidly obese patients (46 women and 14 men) who had undergone gastric bypass surgery for weight reduction and had ≥ 1 year of follow-up. The patients were evaluated using different questionnaires (Symptom Checklist-90-Revised, Body Shape Questionnaire, Rosenberg Self-Esteem Questionnaire, COPE, Medical Outcomes Study Social Support Survey) at 3 points: before surgery, at 6 months postoperatively, and at 1 year postoperatively. To determine the influence of preoperative variables on long-term psychological status, a step-by-step multivariate linear regression analysis was performed, taking P < .05 as statistically significant.
  
  
  RESULTS
  The variables of self-esteem, instrumental support, and coping focused in the emotions were the main preoperative predictors for psychological symptoms 6 months after surgery. Preoperative drug abuse as a strategy of problem solving and mainly body image significantly predicted most of the psychological disorders 1 year after surgery.
  
  
  CONCLUSIONS
  The study of different psychosocial variables in patients before bariatric surgery is an important aid to predict postoperative psychological functioning. Self-esteem and body image were the most influential factors in the postoperative psychological outcome of morbidly obese patients in our study.
authors.affiliation: Department of Surgery, Hospital Clinico Universitario de Valencia, University of Valencia, Valencia, Spain. joaquin.ortega@uv.es
authors.forename: Joaquin
authors.initials: J
authors.lastname: Ortega
authors.forename: Regina
authors.initials: R
authors.lastname: Fernandez-Canet
authors.forename: Sagrario
authors.initials: S
authors.lastname: Alvarez-Valdeita
authors.forename: Norberto
authors.initials: N
authors.lastname: Cassinello
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Baguena-Puigcerver
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001828:Body Image; D004644:Emotions; D005260:Female; D015390:Gastric Bypass / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D011183:Postoperative Complications / Q000523:psychology*; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires