title: Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study.
abstract: BACKGROUND
  Current and previous psychopathology in bariatric surgery candidates is believed to be common. Accurate prevalence estimates, however, are difficult to obtain given that bariatric surgery candidates often wish to appear psychiatrically healthy when undergoing psychiatric evaluation for approval for surgery. Also, structured diagnostic assessments have been infrequently used.
  
  
  METHODS
  The present report concerned 199 patients enrolled in the longitudinal assessment of bariatric surgery study, who also participated in the longitudinal assessment of bariatric surgery-3 psychopathology substudy. The setting was 3 university hospitals, 1 private not-for-profit research institute, and 1 community hospital. All the patients were interviewed independently of the usual preoperative psychosocial evaluation process. The patients were explicitly informed that the data would not be shared with the surgical team unless certain high-risk behaviors, such as suicidality, that could lead to adverse perioperative outcomes were reported.
  
  
  RESULTS
  Most of the patients were women (82.9%) and white (nonwhite 7.6%, Hispanic 5.0%). The median age was 46.0 years, and the median body mass index was 44.9 kg/m2. Of the 199 patients, 33.7% had ≥1 current Axis I disorder, and 68.8% had ≥1 lifetime Axis I disorder. Also, 38.7% had a lifetime history of a major depressive disorder, and 33.2% had a lifetime diagnosis of alcohol abuse or dependence. All these rates were much greater than the population-based prevalence rates obtained for this age group in the National Comorbidity Survey-Replication Study. Also, 13.1% had a lifetime diagnosis and 10.1% had a current diagnosis of a binge eating disorder.
  
  
  CONCLUSIONS
  The current and lifetime rates of psychopathology are high in bariatric surgery candidates, and the lifetime rates of affective disorder and alcohol use disorders are particularly prominent. Finally, binge eating disorder is present in approximately 1 in 10 bariatric surgery candidates.
authors.affiliation: Neuropsychiatric Research Institute, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota 58102, USA. mitchell@medicine.nodak.edu
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Faith
authors.initials: F
authors.lastname: Selzer
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kalarchian
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Devlin
authors.forename: Gladys W
authors.initials: GW
authors.lastname: Strain
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Elder
authors.forename: Marsha D
authors.initials: MD
authors.lastname: Marcus
authors.forename: Steve
authors.initials: S
authors.lastname: Wonderlich
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Christian
authors.forename: Susan Z
authors.initials: SZ
authors.lastname: Yanovski
mesh_terms: D000339:Affect; D001008:Anxiety Disorders / Q000523:psychology; D056912:Binge-Eating Disorder / Q000523:psychology*; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000523:psychology*; D015391:Gastroplasty / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000523:psychology; D009765:Obesity / Q000523:psychology / Q000601:surgery; D057234:Preoperative Period; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011788:Quality of Life / Q000523:psychology
chemical_list: D011619:Psychotropic Drugs