Exploring the Association Between Preoperative Personality Assessment Scales with Postoperative Metabolic Surgery Outcomes

BACKGROUND Metabolic and bariatric surgery (MBS) preoperative evaluation involves a psychosocial assessment, but no formal guidelines dictate how these MBS psychosocial assessments are conducted. The Millon Behavioral Medicine Diagnostic (MBMD) is a broadband personality assessment increasingly used in MBS populations. In this study, we used the MBMD to assess the associations of coping styles, psychiatric indicators, stress moderators, treatment prognostics, and management guides on MBS postoperative weight loss outcomes. SETTING University Hospital, United States. METHODS Ninety-seven participants underwent MBS and preoperative MBMD evaluation at a single institution and were identified through retrospective record review. Preoperative MBMD scores were compared to surgical outcomes, which included reduction in postoperative body mass index (BMI) as compared to preoperative BMI at both 6 (n = 90) and 12 (n = 63) months post procedure. Associations were assessed using Pearson correlations and linear models. RESULTS At 6 months, reduced BMI was positively correlated with increased Inhibited and Dejected coping styles, psychiatric indicators of Anxiety-Tension, treatment prognostics of Interventional Fragility, and management guides for Psychiatric Referral, and higher BMI was associated with increased Confident and Sociable scales. At 12 months, reduced BMI was positively correlated with higher Anxiety-Tension, Social Isolation, and Psychiatric Referral, and negatively correlated to the Confident scale. The Illness Apprehension scale was associated with improved BMI in the Sleeve Gastrectomy group only at 12 months. CONCLUSIONS We found several MBMD scales associated with weight loss following MBS. Given our study is exploratory and associations are unadjusted, these results should be interpreted as associations that can be further explored in future studies to validate these findings.