title: Presurgical assessment of bariatric patients with the Patient Health Questionnaire (PHQ)--a screening of the prevalence of psychosocial comorbidity.
abstract: BACKGROUND
  Bariatric surgery has gained increasing relevance due to the dramatic rise in morbid obesity prevalence. A sound body of scientific literature demonstrates positive long-term outcome of bariatric surgery in decreasing mental and physical health morbidity. Still, there is a need for a manageable presurgical screening to assess major mental disorders. The aim of this study was to assess the frequency of common psychiatric syndromes in bariatric surgery candidates using a computerized version of the Patient Health Questionnaire (PHQ).
  
  
  METHODS
  In a prospective cohort study from August 2009 to July 2011 morbidly obese individuals seeking bariatric treatment were evaluated for mental health disorders using the PHQ (computerized German version).
  
  
  RESULTS
  A total of 159 patients were included in this study. The median age of participants was 42 years, the median BMI was 49 kg/m(2). The PHQ revealed a prevalence of 84 % for mental health disorders, 50 % of the participants had three or more mental health disorders. A high somatic symptom burden (46 %), depressive syndromes (62 %) and anxiety disorders (29 %) were the most frequent psychiatric syndromes. The median number of psychiatric syndromes was 3 for women and 1 for men (p = 0.007). No correlation between BMI and a single syndrome or the sum of syndromes was observed.
  
  
  CONCLUSIONS
  84 % of the patients seeking bariatric treatment were screened positive for at least one mental health disorder. The computerized PHQ with automated reporting appears to be a useful instrument for presurgical assessment of bariatric patients in routine medical settings.
authors.affiliation: Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. palizai@ukaachen.de.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Alizai
authors.affiliation: Department of Medicine, Luisenhospital Aachen, Academic teaching hospital of the RWTH Aachen University, Boxgraben 99, 52064, Aachen, Germany. marenakkerman@aol.com.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Akkerman
authors.affiliation: Department of Surgery, St. Elisabeth Hospital Geilenkirchen, Martin-Heyden-Str. 32, 52511, Geilenkirchen, Germany. d.kaemmer@krankenhaus-geilenkirchen.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kaemmer
authors.affiliation: Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. fulmer@ukaachen.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Ulmer
authors.affiliation: Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. cklink@ukaachen.de.
authors.forename: Christian D
authors.initials: CD
authors.lastname: Klink
authors.affiliation: Institute of Medical Statistics, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. saernst@ukaachen.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Ernst
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. kmathiak@ukaachen.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Mathiak
authors.affiliation: Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. uneumann@ukaachen.de.
authors.forename: Ulf P
authors.initials: UP
authors.lastname: Neumann
authors.affiliation: Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany. vperlitz@ukaachen.de.
authors.forename: Volker
authors.initials: V
authors.lastname: Perlitz
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D050110:Bariatric Surgery / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000523:psychology; D011300:Preoperative Care / Q000379:methods*; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D017678:Sex Distribution; D011795:Surveys and Questionnaires