Psychological Profile and Outcome in Patients Undergoing Gastroplasty for Morbid Obesity
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Eighteen out of 22 consecutive patients undergoing vertical banded gastroplasty were reviewed with regard to preoperative psychological assessment and postoperative outcome. Each patient was initially evaluated by a consultant liaison psychiatrist with regard to previous or ongoing psychological disturbance, and suitability for bariatric surgery. Patients could be grouped into three broad categories: Group A (seven patients) those with no psychiatric abnormality; Group B (six patients) those with minor psychiatric disorders such as sociopathic teenage behaviour, outpatient treatment for depression; and Group C (five patients) those with a history of major psychiatric disturbance such as depressive psychosis and drug dependency. Psychiatric morbidity had no adverse effect in terms of postoperative outcome or weight loss. Mean weight loss of 26%, 30% and 33% was recorded in groups A, B and C respectively after a mean follow-up period of 33 months following gastroplasty. The occurrence of postoperative psychiatric problems correlated closely with preoperative psychological assessment, with none of seven patients in group A but four of the five patients in group C requiring psychiatric management. Our findings indicate that psychiatric illness is not associated with poor outcome following surgery for morbid obesity and such patients should not be excluded if psychiatric support is available before and after surgery.
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