Lamore Kristopher, Kaci Sandra S, Czernichow Sébastien, Bretault Marion, Bouillot Jean-Luc, Naudé Anne-Jeanne, Gribe-Ouaknine Sandra, Carette Claire, Flahault Cécile
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.
Service de Nutrition, Hôpital Ambroise-Paré, 9, avenue Charles-de-Gaulle, 92100, Boulogne-Billancourt, France.
Obes Surg. 2017 Mar;27(3):802-810. doi: 10.1007/s11695-016-2498-0.
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.
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.
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.
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.
国际肥胖症手术候选人指南建议进行术前心理评估。因此，负责肥胖症患者护理的服务团队应至少包括一名心理健康服务提供者（如心理学家或精神科医生）。本研究的目的是评估法国卫生部设立的37家专业肥胖症中心（CSO）的心理和精神科资源及实践情况。
通过电子邮件联系CSO协调员，收集各中心的一般信息（如肥胖症手术数量）。其次，各中心的心理学家和精神科医生填写一份匿名问卷，评估他们的专业实践及护理途径安排。
绝大多数CSO协调员（81%，n = 26/32）回复了我们的调查。这些结果显示，在可用的心理/精神科资源方面存在显著差异和短缺。大多数心理学家（n = 26/31）和精神科医生（n = 10/10）表示，他们仅在术前（56%）或术前和术后（30%）系统地会见新患者；然而，一些心理学家和精神科医生（14%）并未系统地会见所有患者（术前和/或术后）。尽管如此，所有专业人员都提供心理评估，其中约75%提供心理随访，这表明心理学家和精神科医生的实践具有相似性。
我们的结果凸显了法国CSO中心心理/精神评估的地位，并强调其中几家服务机构缺乏心理健康服务提供者。通常不提供术后心理随访。为术后心理或精神科长期随访制定明确建议是合适的。
