title: Psychosocial correlates of pelvic floor disorders in women seeking bariatric surgery.
abstract: BACKGROUND
  Women who struggle with obesity are at a significant risk for pelvic floor disorders (PFDs), defined as urinary incontinence, pelvic organ prolapse, and/or fecal incontinence. The association between PFDs and reduced quality of life has been demonstrated; however, the psychosocial correlates of PFDs in women undergoing bariatric surgery have yet to be examined. The present study explored the potential psychosocial correlates of PFD. The setting was an academic medical center.
  
  
  METHODS
  Data were analyzed from 421 female patients evaluated for bariatric surgery. Based upon a screening questionnaire, participants were dichotomized as women with PFDs (n = 121) and women without PFDs (n = 300). Patients completed the "Minnesota Multiphasic Personality Inventory, 2nd ed., Restructured Form (MMPI-2-RF)," and medical records were reviewed for demographic data, body mass index, substance abuse/dependence history, history of physical and/or sexual abuse, psychiatric medication usage, and psychiatric diagnoses. MMPI-2-RF scales measuring depression, anxiety, somatic symptoms, and social support were examined.
  
  
  RESULTS
  Women with PFDs were significantly older (F(1,420) = 3.87, P < .05) and more likely to evidence a history of substance abuse/dependence (chi-square = 4.53, P < .05) and depression (chi-square = 4.31, P < .05) than women without PFDs. There also was a trend for previous inpatient hospitalization (chi-square = 2.93, P < .09), outpatient behavioral health treatment (chi-square = 2.89, P < .09), and psychotropic medication usage (chi-square = 3.32, P < .07). No differences were found in the objective psychological testing.
  
  
  CONCLUSIONS
  Women with PFDs may be more psychiatrically vulnerable than other bariatric surgery candidates. Additional research on the association among PFDs, substance abuse, and depression is warranted. Future research should consider whether this potential relationship changes postoperative bariatric surgery.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA. merrelj@ccf.org
authors.forename: Julie
authors.initials: J
authors.lastname: Merrell
authors.forename: Stacy
authors.initials: S
authors.lastname: Brethauer
authors.forename: Amy
authors.initials: A
authors.lastname: Windover
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ashton
authors.forename: Leslie
authors.initials: L
authors.lastname: Heinberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications; D005242:Fecal Incontinence / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D010342:Patient Acceptance of Health Care; D059952:Pelvic Floor Disorders / Q000523:psychology*; D056887:Pelvic Organ Prolapse / Q000523:psychology; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications; D014549:Urinary Incontinence / Q000523:psychology; D055815:Young Adult