Poor psychological health and a history of abuse, in bariatric surgery candidates: Levels of pathology in the UK

Abstract

Background: Research literature from Italy and the USA on psychological screening for bariatric surgery candidates, reports high percentages of childhood maltreatment, poor self-esteem, and depression. This paper explores whether bariatric surgery candidates in the UK reveal similar levels of pathology. Method: 300 NHS bariatric surgery candidates, referred for Roux-en-Y gastric by-pass over 18 months, were offered a psychological assessment as part of the multi-disciplinary screening process. 120 candidates completed. The Rosenberg self-esteem scale (RSE). The Becks Depression Inventory (BDI). A semi-structured clinical interview to investigate childhood maltreatment. Results: RES Results showed 11% (n=13) were within the normal range; 89% (n=103) had scores indicating low self-esteem. BDI results showed 3% (n=3) were not depressed; 25% (n=29) had mild-moderate depression; 56% (n=65) had moderate-severe depression; 16% (n=19) had severe depression. Other data from the clinical interview indicated that 77% (n=92) of candidates had experienced emotional abuse in childhood; 68% (n=82) physical abuse; and 42% (n=50) sexual abuse. Conclusion: These data suggest bariatric surgery candidates in the UK present a very similar profile to studies from the USA and Italy. Although this sample has limitations, the study has implications for peri-operative care for this patient group. Such high levels of pathology argue for routine psychological screening and support.