Psychiatric symptoms among prospective bariatric surgery patients: rates of prevalence and their relation to social desirability, pursuit of surgery, and follow-up attendance.

BACKGROUND: There is a very limited empirical literature regarding the psychiatric status of prospective bariatric patients and no studies that examine potential social desirability effects on self-presentation for this patient population.
METHODS: The Psychiatric Diagnostic Screening Questionnaire (PDSQ) was utilized to assess the prevalence of 13 DSM-IV Axis I disorders in a sample of 294 bariatric patients attending a presurgical psychological consultation. Marlowe-Crowne Social Desirability Scale (MCSD) was also included for 256 of these patients. Six-month follow-up data for a sub-sample of 64 patients was obtained to compare the extent of presurgical psychiatric symptoms between individuals who did versus did not pursue the surgery and those who attended versus failed to attend post-operative follow-up appointments.
RESULTS: The results suggested the presence of an Axis I disorder among half of these patients, with comorbidity present in 29.9% of the sample. Highest prevalence rates were suggested for somatization (29.3%), social phobia (18%), hypochondriasis (15%), and obsessive-compulsive disorder (13.6%). Univariate analyses revealed that only MSCD scores were significantly and negatively related to total symptom levels. Analyses of the follow-up data indicated that patients who pursued the surgery had fewer total symptoms. Patients who attended all of their follow-up appointments tended to be older and weighed more at their presurgical evaluation.
CONCLUSION: These findings suggest that significant psychopathology can be found among bariatric patients, and highlight the importance of attending to impression management issues and anxiety spectrum disorders in presurgical psychological evaluations.