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Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity

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Abstract

Objective

Pre-operative psychological assessment is recommended by international guidelines for bariatric surgery candidates. Thereby, service teams caring for bariatric patients should include at least one mental health provider (e.g., a psychologist or psychiatrist). The objective of this study was to evaluate the psychology and psychiatry resources and practices in the 37 specialized obesity centers (CSOs) created by the French Ministry of Health.

Materials and Methods

CSO coordinators were contacted by e-mail to collect general information on the centers (e.g., number of bariatric operations). Secondly, psychologists and psychiatrists of each center completed an anonymous questionnaire assessing their professional practices and their organization of care pathways.

Results

The vast majority of CSO coordinators (81%, n = 26/32) answered our survey. These results show significant differences and shortages in terms of the psychology/psychiatry resources available. Most of the psychologists (n = 26/31) and psychiatrists (n = 10/10) stated that they systematically meet new patients only before surgery (56%) or both before and after the operation (30%); however, some psychologists and psychiatrists (14%) do not systematically meet all the patients (before and/or after surgery). Nevertheless, all the professionals provide psychology assessments, and about 75% of them offer a psychological follow-up, indicating a similarity regarding the practices of psychologists and psychiatrists.

Conclusion

Our results highlight the place of psychological/psychiatric evaluations in French CSOs and emphasize the absence of mental health providers in several of these services. Post-operative psychological follow-up is not usually provided. It would be appropriate to create clear recommendations for post-operative psychological or psychiatric long-term follow-up.

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Acknowledgements

We wish to acknowledge all the psychologists, psychiatrists, and coordinators of specialized care centers for obesity who responded to our survey. We are also grateful to Matthias Bernat, coordinator of the Ile-de-France Specialized Obesity Center, who has been of great help.

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Authors and Affiliations

  1. Laboratoire de Psychopathologie et Processus de Santé, EA 4057 (LPPS), Université Paris Descartes, Sorbonne Paris Cité, 71, avenue Édouard Vaillant, 92774, Boulogne-Billancourt Cedex, France

    Kristopher Lamore & Cécile Flahault

  2. Service de Nutrition, Hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France

    Sandra S. Kaci & Marion Bretault

  3. Service de Nutrition, Centre Spécialisé Obésité IDF Sud, Hôpital Européen Georges-Pompidou, 20, rue Leblanc, 75015, Paris, France

    Sébastien Czernichow, Anne-Jeanne Naudé, Sandra Gribe-Ouaknine & Claire Carette

  4. Université Paris Descartes, 12, rue de l’école de médecine, 75006, Paris, France

    Sébastien Czernichow

  5. Service de chirurgie digestive et métabolique, Hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France

    Jean-Luc Bouillot

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  1. Kristopher Lamore
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Correspondence to Kristopher Lamore.

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Informed consent was obtained from all individual participants included in the study (by ticking a box). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Lamore, K., Kaci, S.S., Czernichow, S. et al. Mental Health Support Provided Throughout the Bariatric Surgery Clinical Pathway in French Specialized Care Centers for Obesity. OBES SURG 27, 802–810 (2017). https://doi.org/10.1007/s11695-016-2498-0

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