Takeaway
- Patients who underwent bariatric surgery had a significantly higher risk for psychiatric illness and deliberate self-harm (DSH) presentations to the emergency department (ED) after surgery than before surgery.
- A history of mental health issues and the development of surgical complications were associated with the need for mental health services after surgery.
Why this matters
- Recent research has suggested an association between bariatric surgery and psychiatric conditions and DSH and suicide.
Study design
- Population-based, retrospective, longitudinal, mirror-image cohort study on 24,766 patients who underwent their index bariatric surgery (2007-2016).
- Funding: St John of God Subiaco Hospital.
Key results
- 39% vs 35.2% patients used psychiatric services after vs before surgery (P=.006).
- The incidence rate ratios (IRRs) for psychiatric diagnosis after surgery:
- Outpatient: IRR, 2.3 (95% CI, 2.3-2.4).
- ED: IRR, 3.0 (95% CI, 2.8-3.2).
- Psychiatric hospitalization: IRR, 3.0 (95% CI, 2.8-3.1).
- Increase in suicidal ideation/DSH rates (IRR, 4.7; 95% CI, 3.8-5.7) was noted after bariatric surgery.
- Increased risk for DSH/suicidal ideation (P<.001) was noted in patients with prior:
- ED presentation with DSH/suicidal ideation (aOR, 4.84);
- hospitalization (aOR, 2.42);
- hospitalization, mental disorders because of psychoactive substance use (aOR, 2.75); and
- hospitalization, mood disorders (aOR, 5.89).
Limitations
- Findings to be interpreted with caution.
Coauthored with Chitra Ravi, MPharm
References
References
