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Screening for Psychiatric Disorders in Bariatric Surgery Candidates with the German Version of the Patient Health Questionnaire

DOI: 10.1155/2014/165818

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Abstract:

Objective. Obesity has been linked to psychiatric disorders in several studies. Prevalence and severity of psychiatric disorders are high in patients undergoing bariatric surgery. Thus, psychiatric assessment of bariatric surgery candidates has become a standard procedure. However, socially desirable responding leads to biased results in self-reported questionnaires. Here, bariatric surgery candidates were screened with the Patient Health Questionnaire (PHQ-D) additionally to the psychiatric examination. Method. 355 bariatric surgery candidates filled in the PHQ-D before the psychiatric examination as a part of the surgery assessment procedure. PHQ-D results were compared to psychiatric diagnoses and body mass index (BMI). Results. Gender ratio, mean BMI, and age were comparable to earlier studies. Depressive and somatization symptoms did not correlate to BMI. However, females showed higher prevalence of psychiatric disorders with elevated syndrome severity in depressive and somatization disorders, as well as more frequent antidepressant intake. Eating disorders and addiction disorders were rarely reported. Conclusion. The findings suggest a socially desirable responding when filling in the PHQ-D before bariatric surgery. The use of the PHQ-D in this patient sample could be augmented by psychometric tests with internal correction and validation scales. Furthermore, psychiatric examination should be separated from the surgery evaluation process. 1. Introduction Obesity has become a relevant socioeconomic and medical problem in developed and new industrialized countries, leading to a 10% increase of obesity rates per decade in the USA [1] and an even greater increase in European countries [2, 3]. In people with a body mass index (BMI) ranging from 30 to 35?kg/m2, expectancy of life declines by 2–4 years, in people with a BMI ranging from 40 to 45?kg/m2 even by 8–10 years [4]. Obese persons, especially women, show higher rates of psychiatric disorders, that is, depressive disorders [5], and they have a higher risk of lifetime depression than normal weight controls [6–12]. Furthermore, prevalence of psychiatric disorders is correlated to increasing BMI [13–15]. Morbidly obese patients (obesity III°) undergoing bariatric surgery show higher prevalence and severity of psychiatric disorders than people with lower degree of obesity (I-II°) [16] or normal weight controls [17–23]. With increasing rates of obesity, bariatric surgery has emerged as an important treatment option in severely obese patients as they do not sufficiently respond to standard weight loss

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