Psychiatric Disorder Comorbidity and Association With Eating Disorders in Bariatric Surgery Patients: A Cross-Sectional Study Using Structured Interview-Based Diagnosis
J Clin Psychiatry 2006;67(7):1080-1085
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Objective: This study examined the
prevalence of DSM-IV Axis I psychiatric disorders in
severely obese bariatric surgery candidates and explored whether eating disorders were
associated with psychiatric comorbidity.
Method: The Structured Clinical Interview
for DSM-IV Axis I Disorders was administered to
a study group of 174 consecutively evaluated bariatric surgery candidates. All evaluations
were completed between September 2002 and November 2004.
Results: Overall, 36.8% of the
participants met criteria for at least one lifetime
psychiatric disorder, with 24.1% meeting criteria for a
current disorder. The most commonly observed lifetime psychiatric diagnoses were affective
disorders (22.4%), anxiety disorders (15.5%), and eating disorders (13.8%). Participants with
eating disorders were significantly more likely
than those without eating disorders to meet criteria
for psychiatric disorders overall (66.7% vs.
26.7%) and specifically for anxiety disorders (45.8%
Conclusions: Psychiatric disorders are
not uncommon among severely obese patients who present for bariatric surgery. The observed
prevalence rates based on structured diagnostic
interviews are lower than previously reported
based on questionnaire, clinical, and chart review
methods but are similar to those reported for
nationally representative samples. Among bariatric
surgery candidates, the presence of eating disorders
is associated with higher rates of other
psychiatric disorders. The findings highlight the
importance of systematic diagnostic assessment using a
structured diagnostic interview for determining the
full spectrum of Axis I disorders.