title: Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity.
abstract: Pre-operative psychological assessment is recommended by international guidelines for bariatric surgery candidates. Thereby, service teams caring for bariatric patients should include at least one mental health provider (e.g., a psychologist or psychiatrist). The objective of this study was to evaluate the psychology and psychiatry resources and practices in the 37 specialized obesity centers (CSOs) created by the French Ministry of Health.
  
  
  
  CSO coordinators were contacted by e-mail to collect general information on the centers (e.g., number of bariatric operations). Secondly, psychologists and psychiatrists of each center completed an anonymous questionnaire assessing their professional practices and their organization of care pathways.
  
  
  
  The vast majority of CSO coordinators (81%, n = 26/32) answered our survey. These results show significant differences and shortages in terms of the psychology/psychiatry resources available. Most of the psychologists (n = 26/31) and psychiatrists (n = 10/10) stated that they systematically meet new patients only before surgery (56%) or both before and after the operation (30%); however, some psychologists and psychiatrists (14%) do not systematically meet all the patients (before and/or after surgery). Nevertheless, all the professionals provide psychology assessments, and about 75% of them offer a psychological follow-up, indicating a similarity regarding the practices of psychologists and psychiatrists.
  
  
  
  Our results highlight the place of psychological/psychiatric evaluations in French CSOs and emphasize the absence of mental health providers in several of these services. Post-operative psychological follow-up is not usually provided. It would be appropriate to create clear recommendations for post-operative psychological or psychiatric long-term follow-up.
authors.affiliation: Laboratoire de Psychopathologie et Processus de Santé, EA 4057 (LPPS), Université Paris Descartes, Sorbonne Paris Cité, 71, avenue Édouard Vaillant, 92774, Boulogne-Billancourt Cedex, France. kristopher.lamore@parisdescartes.fr.
authors.forename: Kristopher
authors.identifier: 0000-0002-8878-2662
authors.initials: K
authors.lastname: Lamore
authors.affiliation: Service de Nutrition, Hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Kaci
authors.affiliation: Service de Nutrition, Centre Spécialisé Obésité IDF Sud, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015, Paris, France.|Université Paris Descartes, 12, rue de l'école de médecine, 75006, Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Czernichow
authors.affiliation: Service de Nutrition, Hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Bretault
authors.affiliation: Service de chirurgie digestive et métabolique, Hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bouillot
authors.affiliation: Service de Nutrition, Centre Spécialisé Obésité IDF Sud, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015, Paris, France.
authors.forename: Anne-Jeanne
authors.initials: AJ
authors.lastname: Naudé
authors.affiliation: Service de Nutrition, Centre Spécialisé Obésité IDF Sud, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015, Paris, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Gribe-Ouaknine
authors.affiliation: Service de Nutrition, Centre Spécialisé Obésité IDF Sud, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Carette
authors.affiliation: Laboratoire de Psychopathologie et Processus de Santé, EA 4057 (LPPS), Université Paris Descartes, Sorbonne Paris Cité, 71, avenue Édouard Vaillant, 92774, Boulogne-Billancourt Cedex, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Flahault
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D050110:Bariatric Surgery / Q000523:psychology*; D019091:Critical Pathways / Q000458:organization & administration*; D005260:Female; D005602:France; D019538:Health Care Surveys; D006295:Health Resources / Q000600:supply & distribution; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008603:Mental Health; D008605:Mental Health Services / Q000600:supply & distribution*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods; D011364:Professional Practice / Q000706:statistics & numerical data
keywords: Bariatric surgery; Care pathway; Psychiatry; Psychology; Specialized obesity centers