BARIATRIC SURGERY AND MULTIPLE PERSONALITY-DISORDER - COMPLEXITIES AND NUANCES OF CARE

Background: Multiple personality disorder (MPD) can occur in patients with morbid obesity in need of bariatric surgery, though few reports n oting this association exist in the literature. Herein we address MPD in morbid obesity, in the context of a patient presenting to us seekin g surgical treatment of her morbid obesity. Methods: A 31-year-old mor bidly obese (BMI 49 kg/m(2)) Hispanic female presented in early 1994 r equesting bariatric surgery. She had been a victim of violent sexual a buse as a young girl. Subsequently, she developed at least three perso nalities, including one male personality. Results: Although she has lo st nearly 45 kg after gastroplasty, her care has been complicated by h er named multiple personalities. While MPD are infrequent and unfamili ar to most care providers, successful outcomes can be promoted with a proper approach. Conclusions: This patient's care illustrates that: (1 ) all personalities must agree to proposed operative intervention; (2) consent must be obtained from the 'true' patient; and (3) postoperati ve care and follow-up must address all personalities for an optimal ou tcome.