This is a comment on the article “Gender-related patterns of psychiatric disorder clustering among bariatric surgery candidates: A latent class analysis”, by Duarte-Guerra et al., J. Affect. Disord. 2018.  The study applied multivariate statistical analysis – the latent class analysis – to determine clusters of patients with obesity III (n = 393), based on their psychiatric diagnosis. Key findings indicated that most of patients were symptomatic and presented comorbid patterns of psychiatric disorders before undertaking surgery.  The patterns were mixed anxiety-bipolar disorders (47%) and anxiety-depression (up to 25%).

The manuscript compares the adjusted rates of psychiatric disorders among three population based representative samples of island and mainland Puerto Ricans, as well as the US population. Results showed similar rates of overall psychiatric disorder between island Puerto Ricans and the US population, but higher rates of substance use disorders (SUD) in Puerto Rico (PR). A prior comparison between island and mainland rates carried almost 30 years ago had shown similar overall rates of psychiatric disorders between the US and the island.

Patients with mental health disorders are at disproportionately greater risk of heart attack and stroke due to accelerated atherosclerotic cardiovascular disease. A three-tiered approach is considered herein to enhance access to primary cardiovascular prevention in clinical practice.