WLS Psych Evaluation

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Psych Evaluation

A psychiatric evaluation to assess psychological status prior

Gastric Bypass. It is a requirement for a patient to see a

psychologist or psychiatrist in preparation for the surgery. The

psychiatric evaluation in preparation for surgery is recommended.

An evaluation by your usual medical doctor will not fulfill these

criteria.

Either a psychologist or a psychiatrist can perform it. A social

worker or other therapist is not an acceptable choice a social

worker or other therapist is not an acceptable choice.

A social worker or other therapist is not an acceptable choice.

The patient should have a routine psychiatric evaluation to rule out

significant eating disorders or other major psychiatric illnesses

that may affect the results of surgery.

Patients with inadequately treated depression need to be

appropriately diagnosed and treated prior to surgery. Alcohol and

drug abuse are also relative contraindications to surgery. The

patient must not have unrealistic expectations of the outcome of

surgery.

Guideline For Psychiatric Evaluation

Purpose of Evaluation

The psychiatric evaluation includes a face-to-face interview with

the patient. A general evaluation usually takes no more than 1 hour

to complete. Several meetings with the patient should not be

necessary.

The psychiatric consultation is requested for the purpose of

assisting in the diagnosis, treatment, or management of a patient's

possible mental disorder or behavioral problem.

The aim of the psychiatric evaluation is to provide answers to the

questions including:

· Patient's competency in deciding to proceed with gastric bypass.

Is the patient competent to decide to proceed with surgery?

· History of Substance Use. Does the patient have a past history of

drug or alcohol use, abuse or dependence? If so what role might this

play in the future of this patient given the expected stress that

occurs in the postoperative period?

· The presence of any Psychiatric diagnosis relevant to the gastric

bypass; in particular is the patient psychotic? If any form of

psychiatric illness is identified then prognosis and treatment

advice should be included.

· Willingness of the psychologist/psychiatrist to follow and treat

the patient in the postoperative period. In addition the letter

should include a commitment to be available for consultation in the

event that depression occurs in the postoperative period.

Patient's ability to handle the stress of the period that follows

surgery

The evaluation should respect the patient's relationship with the

primary clinician and should encourage positive resolution of

conflicts between the patient and the primary clinician if these

emerge as an issue.

Issues to be Addressed in the Psychiatric Evaluation: History of the

Present Illness, Past Psychiatric History, General Medical History,

History of Substance Use, Social History, Occupational History,

Family History, Review of Systems, Mental Status Examination,

Functional Assessment, Information Derived From the Interview

Process.