Pre-Surgical Psychiatric Evaluation Criteria

My surgeon gave me the following ASBS psych eval (for interview), I typed it here ver batim in hopes to give pre-surgery candidates a heads up on what to expect, and lessen the fear associated with the interview/testing process. 

Below are links to the ASMBS Psych Eval (for interview) and links to sample questions as well as a synopsis of the MMPI-2 (computer/pamphlet) of how MMPI-2  is rated.

Suggestions for the Pre-Surgical Assessment of Bariatric Surgery Candidates from the American Society for Bariatric Surgery : 

Behavioral
1. Previous attempts at weight management
2. Eating and dietary styles a. binge eating, b. overeating c. grazing d. night eating syndrome
3. Physical Activity and Inactivity
4. Substance Abuse
5. Health Related Risk Taking Behavior a. impulsive behavior b. compulsive behavior c. compliance with medical treatment d. adherence to self management regimens
Cognitive and Emotional
1. Cognitive Functioning
2. Knowledge of Morbid Obesity and Surgical Interventions
3. Coping Skills, Emotional Modulation, Boundries
Psychopathology Specifically the assessment needs to address
1, Whether there is a history of or current self-destructive or suicidal behavior (ideation, plan or attempt), the outcome of this behavior and the resultant interventions, if any.
2. Any history of psychiatric hospitalizations, the circumstances precipitating this, the type of treatment provided and its efficacy.
3. Any psychiatric history including major affective and psychotic disorders. Relevant information should include a thorough history with regard to onset, course, and treatment history. Risk of possible relapse during the immediate and long-term post operative phases. How the patient plans to meaningfully address these issues should they occur, including both professional and interpersonal supports.
4. The possible impact of the surgery both from the standpoint of symptom resolution as well as potential exacerbation. In general, a documented period of at least 6 consecutive months of good stabilization as it pertains to both symptom and medication management is required before the patient is ready for surgery.
5. Outpatient psychotherapy history including recent and current treatments. Information should be obtained from the patient's treating provider(s) regarding the patient's emotional stability, coping skills, psychological resources and ability to manage life stressors, impulse control issues and compulsions, as well as the client's capacity to follow directions and adhere to self-management guidelines. Treating mental health professionals may also provide valuable information concerning what they believe will be the most difficult change or adjustment for the patient during the post operative phase and what reservations, if any, they have about the candidate's decision to pursue bariatric surgery.
6. The history and course of psychotropic medications. If the candidate is stable on psychotropic medication regime information needs to be gathered about the length of stability, frequency of follow-up visits, or the need for possible titration or revaluation of the current medication regimen prior to surgical procedure.
7. The potential medication issues post surgery. Many medications affect appetite and weight gain. Some medications interact with potential posoperative conditions, e.g., dehydration and some no longer appropriate in the same form as pre-surgery, etc.
Developmental History Areas of note to be gathering during the interview should likely include:
1. Patient recollection about the stability of their childhood, any significant adverse events and long-term impact.
2. Parent availability and stability as well as the quality of the bond with the identified parent
3. Degree and quality attachments in social relationships outside the home
4. Any childhood history of weight-related ridicule and its related impact
5. An understanding of the childhood role that food played, along with any attempt to use it as a source of love, comfort, companionship, control or dissociation.
Current Life Situation
1. Stressors The assessment needs to tap information about: a. What significant life stressors have occured in the past year or are ongoing. Stressors might include significant discord with childern or with one's partner, divorce, death of a loved one, loss of a job, buying a home, moving, or starting college. b. What stressors does the candidate expect in the upcoming year. c. How well the candidate is or is not likely to cope in light of the fact that the rapid, widespread post surgery changes.
2. Utilization of Social Support
Motivations and Expectations
Psychological Testing Instruments and Assessments
Summary
In sum, the pre-surgical assessment addresses whether the candidate is adequately prepared--from a psychosocial perspective -- to go forward with bariatric surgery and whether there is evidence of any barriers that may interfere with patient safety and with adjustment to the surgical procedure. 
                   ________________________________________________________

MMPI-2  first 75 questions: antipolygraph.org/cgi-bin/forums/YaBB.pl

synopsis:     www.psychologistanywhereanytime.com/tests_psychological/psychological_tests_mmpi.htm

THE ASMBS  (American Society for Bariatric Surgery) Pre-Surgical Psych Assessment

                                   http://www.asmbs.org/html/pdf/PsychPreSurgicalAssessment.pdf

0 Comments