title: Psychiatric predictors of surgery non-completion following suitability assessment for bariatric surgery.
abstract: BACKGROUND
  Bariatric surgery is recognized as a treatment for severe obesity; however, little is known about factors influencing patient surgery non-completion. This study explored the relationship between psychiatric factors and patient non-completion during the pre-bariatric surgery suitability assessment.
  
  
  METHODS
  A total of 367 individuals underwent a structured psychiatric interview and were classified as either surgery completers (SC) or surgery non-completers (SNC) if they attended at least one pre-surgery assessment appointment but did not receive surgery.
  
  
  RESULTS
  The results showed that in comparison to the SC group, the SNC group had significantly higher rates of overall past Axis I psychiatric disorders (58.1 vs. 46.6 %, p = 0.035), past anxiety disorders (17.4 vs. 9.4 %, p = 0.03), and past substance use disorders (8.7 vs. 3.7 %, p = 0.03). For specific past psychiatric disorders, the SNC group exhibited significantly higher rates of a past post-traumatic stress disorder (PTSD) (5 vs. 1 %, p = 0.029) and past substance dependence disorder (7 vs. 1 %, p = 0.005). Although overall current psychiatric disorders did not significantly differ between groups, the SNC group had significantly higher rates of current PTSD (2 vs. 0 %, p = 0.049) and current generalized anxiety disorder (4 vs. 0 %, p = 0.005).
  
  
  CONCLUSIONS
  A past history of an anxiety or substance use disorder may play a role in patients not completing the assessment component of the bariatric surgery process. Additional psychosocial support, such as cognitive behavioral therapy or targeted psychoeducation, may help improve patient completion of the pre-surgery assessment phase.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, Canada. sanjeev.sockalingam@uhn.on.ca
authors.forename: S
authors.initials: S
authors.lastname: Sockalingam
authors.forename: S
authors.initials: S
authors.lastname: Cassin
authors.forename: S A
authors.initials: SA
authors.lastname: Crawford
authors.forename: K
authors.initials: K
authors.lastname: Pitzul
authors.forename: A
authors.initials: A
authors.lastname: Khan
authors.forename: R
authors.initials: R
authors.lastname: Hawa
authors.forename: T
authors.initials: T
authors.lastname: Jackson
authors.forename: A
authors.initials: A
authors.lastname: Okrainec
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology; D050110:Bariatric Surgery; D002170:Canada / Q000453:epidemiology; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology