| Congruence between clinical and research-based psychiatric assessment in bariatric surgical candidates. | |
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MedLine Citation:
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PMID: 20727837 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mental health professionals have become increasingly involved in working with bariatric surgical candidates, particularly in performing preoperative psychological evaluations to clear candidates for surgery. The objective of the present study was to examine the concordance of the psychiatric diagnoses obtained during routine clinical evaluation before bariatric surgery and the diagnoses obtained separately at a research facility using the Structured Clinical Interview for DSM (Diagnostic and Statistical Manual of Mental Disorders)-IV axis I disorders. METHODS: The study included 68 consecutively enrolled bariatric surgical candidates who had participated in the Longitudinal Assessment of Bariatric Surgery-3 study. The Structured Clinical Interview for DSM disorders data obtained from the research assessments were compared with the diagnostic data from the routine preoperative psychiatric evaluations. The congruence of the current and lifetime diagnoses was assessed using Cohen's coefficient kappa. RESULTS: Considerable variability was found among the major diagnostic categories, with generally poor agreement found for the current diagnoses. The kappa coefficients tended to be larger for the lifetime diagnoses. The agreement was moderate for any lifetime mood disorder, with a kappa value of 0.45. Regarding any lifetime anxiety, substance use, and eating disorder, the clinical diagnoses rarely concurred with the results from the Structured Clinical Interview for DSM disorders, with a kappa statistic of 0.30, 0.36, and 0.32, respectively. CONCLUSION: The congruence between the diagnoses assigned during the routine clinical psychiatric evaluations and research assessment using the Structured Clinical Interview for DSM disorders was surprisingly low. These conclusions should be considered tentative, given the interval and the possibility of treatment having occurred between the 2 evaluations. Overall, these data raise interesting questions concerning the use of unstructured psychiatric evaluations before bariatric surgery. |
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Authors:
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J E Mitchell; K J Steffen; M de Zwaan; T W Ertelt; J M Marino; A Mueller |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-02-06 |
Journal Detail:
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Title: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Volume: 6 ISSN: 1878-7533 ISO Abbreviation: Surg Obes Relat Dis Publication Date: 2010 Nov-Dec |
Date Detail:
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Created Date: 2010-11-29 Completed Date: 2011-04-04 Revised Date: 2013-02-05 |
Medline Journal Info:
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Nlm Unique ID: 101233161 Medline TA: Surg Obes Relat Dis Country: United States |
Other Details:
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Languages: eng Pagination: 628-34 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Neuropsychiatric Research Institute, Fargo, North Dakota, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Bariatric Surgery / psychology* Comorbidity Diagnostic and Statistical Manual of Mental Disorders* Female Humans Interview, Psychological / methods* Male Mental Disorders / diagnosis* Middle Aged Patient Selection* |
| Grant Support | |
ID/Acronym/Agency:
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DCC-U01 DK066557/DK/NIDDK NIH HHS; U01 DK066471/DK/NIDDK NIH HHS; U01-DK66471/DK/NIDDK NIH HHS; U01-DK66526/DK/NIDDK NIH HHS; U01-DK66555/DK/NIDDK NIH HHS; U01-DK66568/DK/NIDDK NIH HHS; U01-DK66585/DK/NIDDK NIH HHS; U01-DK66667/DK/NIDDK NIH HHS |
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