A longitudinal examination of suicide-related thoughts and behaviors among bariatric surgery patients |
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Authors: | Kathryn H Gordon Wendy C King Gretchen E White Steven H Belle Anita P Courcoulas Faith E Ebel Scott G Engel Dave R Flum Marcelo W Hinojosa Alfons Pomp Walter J Pories Dino Spaniolas Bruce M Wolfe Susan Z Yanovski James E Mitchell |
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Institution: | 1. Neuropsychiatric Research Institute, Fargo, North Dakota;2. Department of Psychology, North Dakota State University, Fargo, North Dakota;3. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania;4. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;5. Weill Cornell Medicine, New York, New York;6. Department of Surgery, University of Washington, Seattle, Washington;7. Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina;8. Department of Surgery, Oregon Health Sciences University, Portland, Oregon;9. Office of Obesity Research, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland |
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Abstract: | BackgroundPast research suggests self-harm/suicidality are more common among adults who have undergone bariatric surgery than the general population.ObjectivesTo compare prevalence of self-harm/suicidal ideation over time and identify presurgery risk factors for postsurgery self-harm/suicidal ideation.SettingThe Longitudinal Assessment of Bariatric Surgery-2 is a cohort study with presurgery and annual postsurgery assessments conducted at 10 U.S. hospitals.MethodsAdults 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).ResultsThe 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).ConclusionsA 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. |
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Keywords: | Suicide Bariatric surgery Suicidal ideation Obesity |
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