Psychological characterisation of severely obese patients: pre- and post-bariatric surgery

Although psychological disorders are more prevalent among candidates for bariatric surgery than among non-obese populations, there is limited knowledge about the impact of this type of surgery on psychopathology. The main goal of this study was to characterize the evolution of psychopathological morbidity among obese patients after surgery. This was an observational longitudinal study. All patients submitted to bariatric surgery between March 2008 and June 2010, in a general hospital located in the south of Portugal were invited to participate. Psychological assessment was done through structured clinical interviews and administration of MCMI-III. Participants were assessed with the same protocol before and after surgery (minimum, 12 months after surgery). Overall, 20 patients (19 women) were assessed. The most prevalent clinical syndromes (axis I) before surgery were: anxiety (40%), dysthymia disorder (20%), somatoform disorder and delusional disorder (both 15%). After surgery, the most prevalent clinical syndromes were: anxiety (40%), bipolar disorder, dysthymia disorder, and delusional disorder (all with 15%). Before surgery, compulsive personality was the most prevalent personality disorder (15%). After surgery, the most prevalent ones were: histrionic personality, compulsive personality disorder, and paranoia (all with 10%). These findings may suggest that bariatric surgery per se is not enough as treatment for the remission of psychopathology among severe obese patients.