title: Associations between psychological test results and failure to proceed with bariatric surgery.
abstract: BACKGROUND
  The reasons why some patients who begin the presurgical process for bariatric surgery fail to complete the procedure are understudied. Previous research implies that psychological factors play a role.
  
  
  OBJECTIVE
  To examine whether scores from baseline psychological testing incrementally predict failure to proceed with bariatric surgery beyond demographic information in patients' medical charts and data derived from a clinical interview.
  
  
  METHODS
  Cleveland Clinic Bariatric and Metabolic Institute.
  
  
  METHODS
  The sample (n = 1160) was mainly female (72.41%), middle aged (mean age = 46.07 yr, SD = 11.70) and of Caucasian descent (65.76%). Hierarchical logistic regressions were conducted to test the incremental validity of baseline Minnesota Multiphasic Personality Inventory-2 Restructured Form scores after controlling for information gathered from the psychological interview and medical charts. Relative risk ratios were calculated to reflect the clinical utility of the results.
  
  
  RESULTS
  In total, 27.16% of patients failed to proceed with bariatric surgery after 1 year or more after a recommendation for surgery from their psychological evaluations. Psychological test scores were substantially associated with failure to proceed with surgery and significantly accounted for up to 6% of additional variance after controlling for psychological interview variables and medical chart data. Elevated scores on Minnesota Multiphasic Personality Inventory-2 Restructured Form scales, such as anxiety and substance use, identify patients at up to 2.5 times greater risk for failing to proceed with bariatric surgery.
  
  
  CONCLUSIONS
  Objective psychological test data-notably, scale scores assessing for substance abuse, anxiety, and demoralization-add to information obtained from a clinical interview and medical records in identifying patients at risk for failing to proceed with bariatric surgery.
authors: Department of Psychological Sciences, Kent State University, Kent, Ohio. Electronic address: rmarek1@kent.edu.
authors: Ryan J
authors: RJ
authors: Marek
authors: Department of Psychological Sciences, Kent State University, Kent, Ohio.
authors: Anthony M
authors: AM
authors: Tarescavage
authors: Department of Psychological Sciences, Kent State University, Kent, Ohio.
authors: Yossef S
authors: YS
authors: Ben-Porath
authors: Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
authors: Kathleen
authors: K
authors: Ashton
authors: Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
authors: Leslie J
authors: LJ
authors: Heinberg
authors: Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
authors: Julie Merrell
authors: JM
authors: Rish
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis; D050110:Bariatric Surgery / Q000523:psychology*; D005260:Female; D006801:Humans; D008950:MMPI / Q000592:standards*; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery; D011300:Preoperative Care; D019966:Substance-Related Disorders / Q000175:diagnosis
keywords: Assessment; Bariatric; Dropout; Incremental validity; Obesity; Psychology