15 research outputs found

    Racial Differences in Psychological Symptoms and Eating Behaviors Among Bariatric Surgery Candidates

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    BACKGROUND: Black patients typically lose less weight than White patients following bariatric surgery; however, the reasons for this racial disparity are unclear. The purpose of the current study was to evaluate whether there are differences in psychiatric symptoms and problematic eating behaviors between White and Black patients pursuing bariatric surgery as this may aid in understanding postsurgical weight loss disparities and inform psychosocial assessment of bariatric candidates. METHODS: A retrospective chart review was conducted of participants (N = 284) who completed a psychological evaluation prior to surgery. Information collected included history of binge eating and purging as well as data from measures administered (i.e., the Hospital Anxiety and Depression Scale, the Emotional Eating Scale, and the Yale Food Addiction Scale 2.0). RESULTS: White patients reported higher levels of eating in response to anger/frustration (p = .03) and eating in response to depression (p = .01) than Black patients. White patients also reported more symptoms of food addiction, a difference that was trending toward significance (p = .05). No significant differences were found on measures of anxiety or depression. CONCLUSION: White patients appear to have higher levels of presurgical problematic eating as compared with Black patients pursuing bariatric surgery; thus, these measurements of problematic eating may not explain the racial disparity in outcomes. However, future research should determine whether measures are valid among diverse populations and identify additional factors that may contribute to racial disparities in bariatric outcomes

    Integration with Community Resources

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    In the United States, emergency departments (EDs) have become primary sites for emergent psychiatric evaluations and crisis intervention. These types of ED visits have been steadily increasing per year and have been found to have significantly longer lengths of stay than for non-mental-health-related visits. Recent data demonstrate a discrepancy in disposition options for mental-health-related complaints as compared to nonmental illness presentations in the ED, with presentations due to mental illness having disproportionately higher rates of hospital admission (Figs. 40.1 and 40.2). ED staff treat acute medical emergencies (e.g., cardiac arrest, stroke, and pulmonary embolism), diagnose and manage new-onset illnesses, and evaluate exacerbations for chronic diseases (congestive heart failure, diabetes, and chronic obstructive pulmonary disorder), understanding that not all sickness requires inpatient medical admission. As the number of mental health presentations continues to increase, ED staff need an understanding of and access to alternative community resources to avoid the exclusive use of hospitalization as the disposition choice for mental health crises. Lack of safe, nonhospital interventions leaves ED staff to over-rely on inpatient levels of care. This, in turn, contributes to the decreased availability of inpatient beds for significant crises, subsequently increasing psychiatric boarding
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