Psychiatric disorders are frequent conditions among obese patients before bariatric surgery. Systematic assessment of patients in the pre-surgical phase is recommended. Prognostic implications of psychiatric disorders on surgery outcome should be demonstrated in follow-up study.

BackgroundClinical assessment of depression is an important part of pre-surgical assessment among individuals with morbid obesity. However, there is no agreed-upon instrument to identify mood psychopathology in this population. We examined the reliability and criterion validity of the clinician-administered Montgomery-Åsberg Depression Rating Scale (MADRS) and the utility of a short version for bariatric surgery candidates.MethodsThe sample was 374 patients with obesity, consecutively recruited from the waiting list of a bariatric surgery clinic of University Hospital, Brazil: women 80 %, mean BMI 47 kg/m2, mean age 43.0 years. The 10-item MADRS was analyzed against the SCID-I. Items that showed small relevance to sample’s characteristics and contribution to data variability were removed to develop the short 5-item version of scale. We calculated the sensitivity and specificity of cutoff points of both versions MADRS, and values were plotted as a receiver operating characteristic curve.ResultsFor the 10-item MADRS, the Cronbach’s alpha coefficient was 0.93. When compared against SCID-I, the best cut-off threshold was 13/14, yielding sensitivity of 0.81 and specificity 0.85. Following items were removed: reduced appetite, reduced sleep, concentration difficulties, suicide thought and lassitude. The 5-item version showed an alpha coefficient of 0.94 and a best cut-off threshold of 10/11, yielding sensitivity of 0.81 and specificity 0.87. Similar overall ability to discriminate depression of almost 90 % was found for both 10-item and 5-item MADRS.ConclusionThe MADRS is a reliable and valid instrument to assess depressive symptoms among treatment-seeking bariatric patients. Systematic application of the abbreviated version of the MADRS can be recommended for enhancing the clinical detection of depression during perioperative period.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-016-0823-8) contains supplementary material, which is available to authorized users.

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Obesity is a chronic condition worldwide and has frequent association with major depression. The Montgomery-Åsberg Depression Rating Scale (MADRS) was applied to obese patients in order to detect briefly and systematically depressive symptoms. The objectives were: to estimate the reliability of the MADRS and to investigate the criterion validity of MADRS. The best cut-off point to detect depressive symptoms was determined in comparison with the Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID-I). The sample was recruited consecutively from the waiting list of a bariatric surgery service of the university clinic. Trained clinical psychologists applied the assessment instruments. The final sample was comprised of 374 class III obese adults (women 79.9 %, mean age 43.3 years [SD 11.6], mean body mass index 47.0 kg/m2 [SD 7.1]). The mean total score of the MADRS was 7.73 (SD 11.33) for the total sample, with a Cronbach's alpha coefficient of .93. Women presented higher mean score than men (8.08 versus 6.33; p = .23). The best cut-off point was 13/14 in accordance with the Receiver Operating Characteristics (ROC) curve analysis, yielding a sensitivity of .81 and specificity of .85. The overall ability to discriminate depression according to area under the curve was .87. The results showed that the MADRS is a reliable and valid scale to detect depressive symptoms among patients seeking treatment in preoperative period, displaying adequate psychometric properties.

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Background Improvement in quality of life is a major outcome after bariatric surgery. Reliable and valid tools that evaluate the quality of life are essential for better clinical practice. Aim Investigate the reliability and validity of the Moorehead-Ardelt Quality of Life-II (MA-II) among Brazilian-Portuguese-speaking patients with severe obesity. Methods The sample was composed of 387 patients (mean age 43 years, 78.8% women, median Body Mass Index [BMI]: 46.5 kg/m2) invited from the waiting list of a university-based bariatric center. In addition, psychiatric comorbidities, the severity of depressive symptoms, and the patient's level of functioning were evaluated by the Structured Clinical Interview (SCID), Montgomery-Åsberg Depression Rating Scale (MADRS), and Global Assessment of Functioning (GAF), respectively. Results The internal consistency of the MA-II was acceptable, as indicated by Cronbach's alpha coefficient of 0.70. The total score of MA-II was significantly correlated with the severity of the depressive symptoms (MADRS) and the level of global functioning (GAF). In turn, the BMI was inversely correlated with physical activity and job performance dimensions of the MA-II. The more BMI increases, the quality of life worsens. Conclusion The MA-II is a reliable and valid instrument to evaluate the quality of life among Brazilian-Portuguese-speaking patients with severe obesity. The questionnaire is a helpful and quick tool for assessing the quality of life of bariatric patients.