Psychosocial evaluation of bariatric surgery candidates: A survey of present practices
Psychosocial evaluation of bariatric surgery candidates: A survey of present practices
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DOI：
10.1097/01.psy.0000174173.32271.01
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发表时间：
2005-09-01
影响因子：
3.3
通讯作者：
Schirmer, B
中科院分区：
文献类型：
--
作者：
Bauchowitz, AU;Gonder-Frederick, LA;Schirmer, B
目的：减肥手术的成功结果在很大程度上取决于患者坚持术后行为改变的能力。在患者同意手术之前，通常需要进行彻底的心理评估。除了标准的精神病学访谈外，似乎还需要对该手术的行为成分进行评估。没有关于如何进行这种评价的统一准则。这项调查旨在收集有关心理健康专业人员参与减肥手术计划的程度以及他们评估减肥手术候选人的方法的信息。方法：向188个减肥手术项目邮寄心理评估实践调查问卷。81份调查被退回。结果：88%的项目需要患者接受心理评估，几乎一半需要正式的标准化心理评估。目前的非法药物使用、精神分裂症的活跃症状、严重的智力迟钝和缺乏手术知识是最常见的禁忌症，使患者无法获得手术批准。讨论：大多数项目使用心理评估；然而，手术的排除标准差别很大。为减肥手术候选人的筛选建立统一的指导方针是必要的。提供了如何开始这一过程的建议。需要对术后成功的行为和认知预测因素进行更多的研究。
Objective: Successful outcome for bariatric surgery is largely dependent on patients' ability to adhere to postoperative behavior changes. A thorough psychological evaluation is often required before patients' approval for surgery. In addition to a standard psychiatric interview, assessment of behavioral components specific to this surgery seems indicated. No uniform guidelines exist on how to conduct such an evaluation. This survey was designed to collect information on the level of involvement of mental health professionals with bariatric surgery programs and their approach to evaluating bariatric surgery candidates. Methods: Surveys about psychological evaluation practices were mailed to 188 bariatric surgery programs. Eighty-one surveys were returned. Results: Eighty-eight percent of programs require patients to undergo a psychological evaluation and almost half require formal standardized psychological assessment. Current illicit drug use, active symptoms of schizophrenia, severe mental retardation, and lack of knowledge about the surgery were the most commonly cited contraindications, preventing patients from gaining approval for surgery. Discussion: The majority of programs use psychological evaluations; however, the exclusion criteria for surgery vary greatly. Establishing uniform guidelines for the screening of bariatric surgery candidates is necessary. Suggestions on how to begin this process are provided. More research about behavioral and cognitive predictors of postsurgical success is needed.