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Childhood Maltreatment and Psychiatric Morbidity in Bariatric Surgery Candidates

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Abstract

Background

This study used standardized assessments to evaluate the association between childhood maltreatment (i.e., emotional, physical, and sexual abuse and emotional and physical neglect) and Axis I and II psychiatric disorders in patients presenting for bariatric surgery.

Methods

Participants (N = 230) provided demographic information and completed the Childhood Trauma Questionnaire, short form. The Structured Clinical Interview for the DSM-IV was used to assess Axis I clinical disorders and Axis II personality disorders.

Results

Approximately 66% of participants had a history of childhood maltreatment. Individuals reporting childhood maltreatment had a greater number of lifetime Axis I diagnoses than did those without, although the effect for physical neglect was no longer significant after controlling for multiple comparisons. With respect to specific Axis I diagnoses, a history of emotional or sexual abuse was associated with increased rates of lifetime mood and anxiety disorder diagnoses. Emotional neglect also was associated with increased rates of mood disorder diagnoses, and physical abuse was associated with increased rates of substance use disorders. There was no significant association between childhood maltreatment and personality psychopathology.

Conclusion

This study confirms high rates of childhood maltreatment in patients presenting for bariatric surgery that are associated with increased prevalence of lifetime mood, anxiety, and substance use disorders. Future prospective studies should include evaluation of a broad range of mental health and childhood experiences to tease apart the nature of the relationships between these factors and their potential impact on post-surgical outcomes.

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Acknowledgments

Research was supported by a seed money grant from the University of Pittsburgh Obesity and Nutrition Research Center (P30 DK46204) and a career development award from the National Institute of Diabetes, Digestive and Kidney Diseases (K23 DK62291).

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Authors and Affiliations

  1. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Jennifer E. Wildes, Melissa A. Kalarchian, Marsha D. Marcus & Michele D. Levine

  2. Department of Minimally Invasive Bariatric and General Surgery, UPMC Shadyside Medical Center, 5200 Centre Avenue, Pittsburgh, PA, 15232, USA

    Anita P. Courcoulas

Authors
  1. Jennifer E. Wildes
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  2. Melissa A. Kalarchian
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  3. Marsha D. Marcus
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  4. Michele D. Levine
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  5. Anita P. Courcoulas
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Correspondence to Jennifer E. Wildes.

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Wildes, J.E., Kalarchian, M.A., Marcus, M.D. et al. Childhood Maltreatment and Psychiatric Morbidity in Bariatric Surgery Candidates. OBES SURG 18, 306–313 (2008). https://doi.org/10.1007/s11695-007-9292-y

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  • DOI: https://doi.org/10.1007/s11695-007-9292-y

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