50 Analysing the Effectiveness of Pre-Operative Psychiatric Evaluation Prior to Metabolic Bariatric Surgery: A 14-Year Retrospective Study

Abstract Aim Preoperative psychiatric evaluation (PPE) is a standard component of metabolic bariatric surgery protocols. This study aims to assess the efficacy of PPE in a tertiary care setting, determining whether psychiatric evaluations by a psychiatrist are necessary versus whether surgeon-administered pre-operative psychiatric questionnaires are sufficient. Method We conducted a retrospective review of patient data from 2006 to 2020 at Walsall Manor Hospital, U.K., focusing on individuals who underwent metabolic bariatric surgeries. The analysis encompassed both electronic & paper-based records to identify the methods used in pre-operative psychiatric evaluations. All patients had their body mass index (BMI) measured at the time of surgery, followed by a reassessment for two years post-surgery. The chi-square test of independence was used to explore the association between psychological risk assessments and actual recurrent weight gain. Results Our cohort consisted of 481 patients (361 females & 120 males), with a mean age of 45.18 years at the time of surgery. The procedures included sleeve gastrectomy (217), gastric bypass (197), & gastric band (67). The analysis identified a marginal association between psychological risk assessments & actual weight regain, with a p-value of 0.069. Conclusions The findings highlight a marginal correlation between pre-operative psychiatric evaluations and recurrent weight gain post-surgery, questioning the absolute predictive value of these assessments. This study suggests integrating surgeon-administered psychiatric questionnaires with targeted psychiatric evaluations for high-risk patients with obesity may offer a balanced approach to pre-operative psychiatric assessment in metabolic bariatric surgery protocols & may reduce the time to surgery for patients and decrease the cost burden on the healthcare system.