title: Childhood parental loss and bipolar spectrum in obese bariatric surgery candidates.
abstract: BACKGROUND
  Early adverse experiences such as sexual, verbal, or physical abuse and parental neglect have been associated with a higher risk of weight or eating problems in adulthood, and death or prolonged separation from parents during childhood has been implicated as a correlate of adult psychiatric disorders that are widely represented in obese subjects seeking bariatric surgery.
  
  
  OBJECTIVE
  The aim of this study was to examine the rate of childhood parental loss in obese bariatric surgery candidates and explore its association with a psychiatric diagnosis and clinical and weight/eating-related characteristics.
  
  
  METHODS
  The current and lifetime psychiatric diagnoses of 120 consecutive bariatric patients undergoing pre-surgical psychiatric consultation were assessed using a modified version of the Structured Clinical Interview for DSM-IV (SCID-CV), and information relating to parental death or separation before the age of 17 years was collected using a semi-structured interview. The rate of childhood parental loss was compared with that of an always slender population sharing the same psychiatric diagnosis.
  
  
  RESULTS
  91.7% of the obese subjects were diagnosed as having a bipolar spectrum disorder. Overall, 28% of the patients reported a childhood parental death or separation. Early parental loss was not equally distributed in the different diagnostic subgroups, being more frequent in those with bipolar II disorders; the always slender subjects with bipolar II disorders showed a lower rate of early parental loss.
  
  
  CONCLUSIONS
  The study findings confirm the association between obesity and bipolar disorders and suggest that early parental loss may play a role in the development of obesity in bipolar II subjects.
authors.affiliation: Department of Psychiatry, Luigi Sacco University Hospital, Milan, Italy. spdc@hsacco.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Alciati
authors.forename: Felice
authors.initials: F
authors.lastname: Gesuele
authors.forename: Andrea
authors.initials: A
authors.lastname: Rizzi
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Sarzi-Puttini
authors.forename: Diego
authors.initials: D
authors.lastname: Foschi
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003643:Death; D005260:Female; D006801:Humans; D015994:Incidence; D007406:Interview, Psychological / Q000379:methods; D008016:Life Change Events; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000523:psychology / Q000601:surgery; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*