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A longitudinal examination of suicide-related thoughts and behaviors among bariatric surgery patients.

ABSTRACT: BACKGROUND:Past research suggests self-harm/suicidality are more common among adults who have undergone bariatric surgery than the general population. OBJECTIVES:To compare prevalence of self-harm/suicidal ideation over time and identify presurgery risk factors for postsurgery self-harm/suicidal ideation. SETTING:The Longitudinal Assessment of Bariatric Surgery-2 is a cohort study with presurgery and annual postsurgery assessments conducted at 10 U.S. hospitals. METHODS:Adults with severe obesity undergoing bariatric surgery between March 2006 and April 2009 (n?=?2458). Five-year follow-up is reported. Self-reported history of suicidality assessed retrospectively via the Suicide Behavior Questionnaire-Revised (SBQ-R) and self-reported self-harm/suicidal ideation assessed prospectively via the Beck Depression Inventory-Version 1 (BDI-1). RESULTS:The SBQ-R was completed by 1540 participants; 2217 completed the BDI-1 pre- and postsurgery. Over 75% of participants were female, with a median age of 46 years and body mass index of 45.9 kg/m2. Approximately one fourth of participants (395/1534) reported a presurgery history of suicidal thoughts or behavior (SBQ-R). The prevalence of self-harm/suicidal ideation (BDI-1) was 5.3% (95% confidence interval [CI], 3.7-6.8) presurgery and 3.8% (95% CI, 2.5-5.1) at year 1 postsurgery (P?=?.06). Prevalence increased over time postsurgery to 6.6% (95% CI, 4.6-8.6) at year 5 (P?=?.001) but was not significantly different than presurgery (P?=?.12). CONCLUSIONS:A large cohort of adults with severe obesity who underwent bariatric surgery had a prevalence of self-harm/suicidal ideation that may have decreased in the first postoperative year but increased over time to presurgery levels, suggesting screening for self-harm/suicidality is warranted throughout long-term postoperative care. Several risk factors were identified that may help with enhanced monitoring.

SUBMITTER: Gordon KH

PROVIDER: S-EPMC6481310 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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A longitudinal examination of suicide-related thoughts and behaviors among bariatric surgery patients.

Gordon Kathryn H KH King Wendy C WC White Gretchen E GE Belle Steven H SH Courcoulas Anita P AP Ebel Faith E FE Engel Scott G SG Flum Dave R DR Hinojosa Marcelo W MW Pomp Alfons A Pories Walter J WJ Spaniolas Dino D Wolfe Bruce M BM Yanovski Susan Z SZ Mitchell James E JE

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery 20181206 2

<h4>Background</h4>Past research suggests self-harm/suicidality are more common among adults who have undergone bariatric surgery than the general population.<h4>Objectives</h4>To compare prevalence of self-harm/suicidal ideation over time and identify presurgery risk factors for postsurgery self-harm/suicidal ideation.<h4>Setting</h4>The Longitudinal Assessment of Bariatric Surgery-2 is a cohort study with presurgery and annual postsurgery assessments conducted at 10 U.S. hospitals.<h4>Methods< ...[more]

PMID: 31010651

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Project description:Severe obesity in childhood is a major health problem with few effective treatments. Weight-loss surgery (WLS) is being used to treat severely obese adolescents, although with very limited data regarding surgical safety for currently used, minimally invasive procedures.To assess the preoperative clinical characteristics and perioperative safety outcomes of severely obese adolescents undergoing WLS.This prospective, multisite observational study enrolled patients from February 28, 2007, through December 30, 2011. Consecutive patients aged 19 years or younger who were approved to undergo WLS (n?=?277) were offered enrollment into the study at 5 academic referral centers in the United States; 13 declined participation and 22 did not undergo surgery after enrollment, thus the final analysis cohort consisted of 242 individuals. There were no withdrawals.This analysis examined preoperative anthropometrics, comorbid conditions, and major and minor complications occurring within 30 days of operation. All data were collected in a standardized fashion. Reoperations and hospital readmissions were adjudicated by independent reviewers to assess relatedness to the WLS procedure.The mean (SD) age of participants was 17.1 (1.6) years and the median body mass index (calculated as weight in kilograms divided by height in meters squared) was 50.5. Fifty-one percent demonstrated 4 or more major comorbid conditions. Laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding were performed in 66%, 28%, and 6% of patients, respectively. There were no deaths during the initial hospitalization or within 30 days of operation; major complications (eg, reoperation) were seen in 19 patients (8%). Minor complications (eg, readmission for dehydration) were noted in 36 patients (15%). All reoperations and 85% of readmissions were related to WLS.In this series, adolescents with severe obesity presented with abundant comorbid conditions. We observed a favorable short-term complication profile, supporting the early postoperative safety of WLS in select adolescents. Further longitudinal study of this cohort will permit accurate assessment of long-term outcomes for adolescents undergoing bariatric surgery.clinicaltrials.gov Identifier: NCT00474318.

Dataset Information

A longitudinal examination of suicide-related thoughts and behaviors among bariatric surgery patients.

Publications

A longitudinal examination of suicide-related thoughts and behaviors among bariatric surgery patients.

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