title: Prevalence of psychiatric disorders before and 1 year after bariatric surgery: the role of shame in maintenance of psychiatric disorders in patients undergoing bariatric surgery.
abstract: OBJECTIVE
  The present study examined prevalence of psychiatric disorders before and 1 year after weight loss surgery. Furthermore, we studied if level of pre-operative shame could be a maintaining factor for psychiatric disorders at 1-year follow-up.
  
  
  METHODS
  One-hundred and twenty-seven patients (F/M: 94/33) with mean body mass index (BMI) ± standard deviation (s) =45.3±5.2 kg/m(2) and mean age 41.3±10.3 years participated in the study. Eighty-seven patients met for follow-up 1 year after surgery. Psychiatric disorders were assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.) and the Structured Clinical Interview (SCID-II). Levels of depression, anxiety and shame were assessed by the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Internalized Shame Scale (ISS).
  
  
  RESULTS
  Sixty-one patients (48%) at pre-operative assessment and 16 patients (18%) at 1-year follow-up had a comorbid psychiatric disorder. The strongest predictor of post-operative psychiatric disorder was pre-operative psychiatric disorder, odds ratio of 27.7 (95% CI for EXP (B) 3.2-239.8, P =0.003). Pre-operative level of shame (higher than 50-point ISS score) was also a significant predictor for post-operative psychiatric disorders, odds ratio of 9.1 (95% CI for EXP (B) 1.8-44.4, P =0.007).
  
  
  CONCLUSIONS
  There was a significant reduction in prevalence of psychiatric disorders from pre-operative assessment to follow-up 1 year after surgery. Level of shame at pre-operative assessment was associated with maintenance of psychiatric problems. This finding is of clinical importance, since psychiatric disorders persisting after bariatric surgery have strong impact on the course of weight loss and quality of life.
authors.affiliation: Section of Mental Health Research, Haugesund Hospital, Helse Fonna HF, Haugesund, Norway. haldis.johanne.oekland.lier@helse-fonna.no
authors.forename: Haldis Økland
authors.initials: HØ
authors.lastname: Lier
authors.forename: Eva
authors.initials: E
authors.lastname: Biringer
authors.forename: Bjarte
authors.initials: B
authors.lastname: Stubhaug
authors.forename: Tone
authors.initials: T
authors.lastname: Tangen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D050110:Bariatric Surgery / Q000523:psychology*; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D011184:Postoperative Period; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012752:Shame; D015431:Weight Loss