ISSN 1302-6631
 

Review Article 


Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline

Güzin M. Sevinçer.

Abstract
Bariatric surgery operations in Turkey increasingly expands as well as in the world. Growing literature supports that psychiatric and psychosocial assessment of obesity surgery patients are crucial. Many of the weight loss surgery centers applies multidisciplinary approach including psychiatric and psychological assessments. However, a worldwide accepted guideline to manage obesity surgery patients regarding psychiatric and psychosocial assessment, is not available. Instead, there are variety of expert consensus texts are used by different centers which taken into account by the health authorities. Unfortunately, neither expert consensus texts nor a guideline are available yet, in Turkey. Patients, bariatric surgeons and even mental health professionals have been underestimated the importance of psychiatric evaluation in bariatric surgery in Turkey. The main themes to be discussed in this context are the necessity of psychiatric evaluation, assessment methods, qualification and competency of the professionals and the quality of the assessments.
Patients should be screened routinely in terms of the presence of eating disorders, mood disorders, substance use disorders and other psychiatric disorders in both pre- and surgical period and those who needed should be follow for further psychiatric evaluation and treatment. Careful psychiatric and psychosocial assessment of the patients is important with regard to the improvement of the quality of life as well as preventing adverse effects on weight loss in the post-operative period.
This article is aimed to review the current literature and guidelines in order to explore the main issues in psychiatric aspects of the assessment of bariatric surgery patients. It is also aimed that this article provide an orientation for the guidelines will be prepared in Turkey. This article has focused on the assessment of the common psychiatric conditions before and after bariatric surgery. Effectiveness of the treatments, selection of the interventions and advantages/disadvantages of psychopharmacologic, psychotherapeutic or psychosocial interventions are excluded from the scope of this article. It is obvious that to discuss these issues in the relevant platforms and to develop a guideline, are needed in order to reach a common approach.

Key words: Obesity, Obesity Surgery, Psychiatric Evaluations, Guideline



Türkiye’de obezite cerrahisinde psikiyatrik değerlendirme: Uzlaşı ve kılavuz gereksinmesi

Ozet
Obezite cerrahisi dünyada olduğu gibi Türkiye’de de giderek yaygınlık kazanmaktadır. Obezite cerrahisinde ruhsal-toplumsal değerlendirmenin önemli olduğu her geçen gün artan literatürle de desteklenmektedir. Bu doğrultuda birçok kilo verme cerrahisi merkezi ruhsal-toplumsal değerlendirmeyi de içeren multidisipliner hasta değerlendirme yaklaşımını uygulamaktadır. Ancak bu konuda henüz dünyada kabul görmüş tek bir uzlaşı kılavuzu yoktur. Bu çerçevede farklı merkezler tarafından yayımlanmış farklı uzman uzlaşı metinleri olup sağlık otoriteleri tarafından dikkate alınmaktadır. Türkiye’de ise henüz böyle bir uzman uzlaşısı ve kılavuzu yoktur.
Türkiye’de obezite cerrahisinde ruhsal-toplumsal değerlendirmenin önemi obezite cerrahları, hastalar ve hatta ruh sağlığı çalışanları tarafından bile henüz hak ettiği ilgiyi görmemektedir. Ruhsal-toplumsal değerlendirmenin gerekli olup olmadığı, değerlendirme yöntemlerinin nasıl olması gerektiği, değerlendirmeyi yapacak kişilerin niteliği ve yetkinlikleri, yapılan değerlendirmenin kalitesi ve yeterliliği tartışılmaya gerek duyulan konulardan başlıcalarıdır.
Obezite cerrahisi hastalarının gerek cerrahi işlem öncesi, gerekse cerrahi sonrası yeme bozuklukları, duygudurum bozuklukları, madde kullanım bozuklukları ve diğer ruhsal bozukluklar açısından rutin olarak değerlendirilmeleri ve gerekli olguların daha dikkatli tedavi ve izleme sürecine alınması için ruhsal değerlendirmeye sunulması gerekmektedir. Bu hastaların ruhsal-toplumsal yönden dikkatle ele alınması, bireysel olarak yaşam kalitesini arttırdığı gibi, ameliyat sonrası kilo verme üzerine olumsuz etkileri engellemesi bakımından da önemli bir konudur.
Bu yazıda ulaşılabilen literatür ve kılavuzlar gözden geçirilip, obezite cerrahisinde ruhsal değerlendirmedeki temel konuların bir derleme biçiminde sunulması ve Türkiye’de yapılacak olan uzman uzlaşı metinleri için rehberlik etmesi amaçlanmıştır. Makalede obezite cerrahisi öncesinde ve sonrasında rastlanan psikiyatrik durumların değerlendirilmesine odaklanılmış olup gerek psikofarmakoloji, gerek psikoterapi, gerekse ruhsal-toplumsal girişimlerin etkinliği, seçimi, avantaj ve dezavantajları bu makalenin kapsamı dışında bırakılmıştır.
Bu konuların ilgili platformlarda tartışılması ve ortak bir yaklaşım ortaya konabilmesi için uzman uzlaşı kılavuzlarının geliştirilmesinin gerekliliği açıktır.

Anahtar Kelimeler: Obezite, obezite cerrahisi, ruhsal-toplumsal değerlendirme, kılavuz


 
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How to Cite this Article
Pubmed Style

Guzin M. Sevincer. [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. Anadolu Psikiyatri Derg. 2016; 17(Supplement 2): 5-45. Turkish. doi:10.5455/apd.223825


Web Style

Guzin M. Sevincer. [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. http://www.anadolupsikiyatri.net/?mno=223825 [Access: November 21, 2018]. Turkish. doi:10.5455/apd.223825


AMA (American Medical Association) Style

Guzin M. Sevincer. [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. Anadolu Psikiyatri Derg. 2016; 17(Supplement 2): 5-45. Turkish. doi:10.5455/apd.223825



Vancouver/ICMJE Style

Guzin M. Sevincer. [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. Anadolu Psikiyatri Derg. (2016), [cited November 21, 2018]; 17(Supplement 2): 5-45. Turkish. doi:10.5455/apd.223825



Harvard Style

Guzin M. Sevincer (2016) [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. Anadolu Psikiyatri Derg, 17 (Supplement 2), 5-45. Turkish. doi:10.5455/apd.223825



Turabian Style

Guzin M. Sevincer. 2016. [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. Anatolian Journal of Psychiatry, 17 (Supplement 2), 5-45. Turkish. doi:10.5455/apd.223825



Chicago Style

Guzin M. Sevincer. "[Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]." Anatolian Journal of Psychiatry 17 (2016), 5-45. Turkish. doi:10.5455/apd.223825



MLA (The Modern Language Association) Style

Guzin M. Sevincer. "[Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]." Anatolian Journal of Psychiatry 17.Supplement 2 (2016), 5-45. Print.Turkish. doi:10.5455/apd.223825



APA (American Psychological Association) Style

Guzin M. Sevincer (2016) [Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline]. Anatolian Journal of Psychiatry, 17 (Supplement 2), 5-45. Turkish. doi:10.5455/apd.223825





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