Pre-Operative Bariatric Surgery Psychological Evaluation

Psychological evaluation is for better understanding of readiness, behavioral demanding situations, and emotional elements that may affect a person’s coping and adjustment through surgical operation. Basically, evaluation is to determine the presence of any psychiatric conditions that would impair the patient’s capability to address the surgical operation. Symptoms such as anxiety and depression can affect patient’s coping process through the surgery experience.

The mental health evaluation, like cases in which patients have history of abuse or any mental health issues, hence for any of these issues patients need information regarding proper treatment resources. Once these things are assessed, the psychologist evaluates the facts and highlights any regions desiring special interest.

The methodology for evaluating patients has four steps, first and the basic step is that the Pre-operative psychological evaluation must be conducted by a psychologist, psychiatrist or a person qualified in the assessment and diagnosis of mental health illness.

Second step is of conducting different reviews and tests like a review of medical record for including both mental and behavioral health record. A clinical review is also recommended. In addition to that, different recommended interviews must be administered, such as

• Alcohol Use Disorder Test-core (AUDIT-C)
• Drug Abuse Screening Test (DAST© )
• Millon Behavioral Medicine Diagnostic (MBMD© )
• Multidimensional Health Locus of Control (MHLC)

In the third step, issues that are part of the first two steps, need to be assessed. These issues can be different disorders like mental disorder, personality disorder or substance use disorders. Patients are asked why they have decided to have a surgery, because it’s really important that they have realistic expectations about what can be achieved.

The social and family situation is also an important issue that need to be assessed like what type of people the patient is surrounded with such as family members, friends, and colleagues. Patients are even asked how they have reacted to the decision of the surgery. Finally in the last step, for the patients with mental health and behavioral issues, a proper follow up must be arranged.

There are recommendations in which the result of the Pre-operative Bariatric Surgery Psychological evaluation must fall, like the patient can either be a poor candidate or a good candidate but in both of the cases there are few assessments for the patients for resolving the issues, hence they are different for different cases.

Case 1:
If a patient has a history of multiple suicide attempts within past 5 year and alcohol use disorder for past 6 months then the patient is recommended as a poor candidate for bariatric surgery, the patient should be reassessed at a future date when these issues are resolved.

Case 2:
If a patient is facing mental illness, unstable social illness or other behavioral problems then the patient is a poor candidate for bariatric surgery, but reassessment is recommended after a period of focused behavioral intervention.

Case 3:
If a patient is having mid behavioral problems, low self-efficiency and well controlled mental illness from a behavioral health perspective, the patient is deemed to be a good candidate for bariatric surgery. It is recommended that the patient continues to participate and patient is deemed to be a good candidate for bariatric surgery.