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.