A Review of the Role of Psychosocial Evaluation in Organ Transplant and Bariatric Surgery

Abstract

CME Educational Objectives 1. Review the evidence related to pre-transplant psychiatric evaluations and its relation to patient outcomes. 2. Discuss the management of psychiatric disorders in organ transplant patients. 3. Review the evidence related to psychiatric evaluations of bariatric surgery candidates and the impact it has on outcomes. Advanced medical procedures are expensive, often risky, and pose both short- and long-term challenges for those who receive them. Psychiatric assessment prior to many procedures is often requested, either due to regulations or convention. However, the evidence in favor of these evaluations ranges from some obvious benefits to near conjecture, and while common sense and clinical judgment can lead evaluators to focus on those aspects of the patient’s life that seem relevant, evidence (where available) should guide the work. Organ transplantation and bariatric surgery are two examples of these high-stakes medical interventions that involve psychiatry and related mental health fields during the evaluation process. A review of some of the evidence and areas of uncertainty follows.