Depression and Suicide After Bariatric Surgery
AbstractPurpose of ReviewIndividuals with morbid obesity benefit from bariatric surgery with respect to weight loss and decreases in obesity-related somatic disorders. This paper focuses on psychosocial outcomes and provides a narrative review of recent meta-analyses and controlled studies concerning postoperative depression and suicide.Recent FindingsConsiderable evidence shows short- and medium-term improvement in depressive symptoms after surgery. However, a subgroup of patients exhibits erosion of these improvements or new onset of depression in the long run. Some studies have found an increased risk for suicide among postoperative patients.SummaryProspective longitudinal examinations of factors contributing to the increased risk for postoperative depression and suicide and the interaction between these factors are warranted. The inclusion of mental health professionals in bariatric teams would help to monitor patients for negative psychosocial outcomes and to identify those patients who are vulnerable to depression, suicide, and any other forms of deliberated self-harm following surgery.
Extant literature warns of elevated suicide risks in adults post-bariatric surgery, making understanding risks for adolescent patients imperative.
ConclusionsWeight loss is insufficient to determine a change in psychological distress following surgery. Physicians and other health professionals who treat bariatric surgery patients should be encouraged to asses BID pre- and post-surgery, as it is a sensitive indicator of improvement of psychological well-being after surgery.
There is an increased risk of suicidal behavior after bariatric surgery, but underlying causes are poorly understood. Also, little is known about suicidal ideation in those who undergo bariatric surgery as teenagers.
Elevated suicidal risk for adult bariatric patients is concerning. Adolescence and young adulthood (AYA) are high risk periods for suicidal thoughts and behaviors (STBs). Understanding how STBs and associated risk factors unfold for adolescents following bariatric surgery is critical to inform care guidelines.
PURPOSE OF REVIEW: Individuals with morbid obesity benefit from bariatric surgery with respect to weight loss and decreases in obesity-related somatic disorders. This paper focuses on psychosocial outcomes and provides a narrative review of recent meta-ana...
CONCLUSIONS: Significantly higher rates of childhood maltreatment were found within non-surgery patients with obesity in comparison to bariatric surgery patients. Childhood maltreatment did not predict poorer outcomes after surgery. Since history of childhood maltreatment may increase the risk for psychological disturbances, regular screening and, if necessary, psychological support should be offered to both groups. LEVEL OF EVIDENCE: Evidence obtained from well-designed cohort or case-control analytic studies, Level III. CLINICAL TRIAL REGISTRATION: Deutsches Register Klinischer Studien-German Clinical Trials Re...
AbstractPurpose of ReviewThe purpose of this paper is to review the current status of research on psychosocial concerns following bariatric surgery.Recent FindingsBariatric surgery has a positive overall impact on weight and obesity-related comorbidities, as well as a positive short-term impact on mental health and psychosocial functioning. Nonetheless, research has documented a number of different psychosocial concerns that may emerge following surgery including maladaptive eating, substance use disorders, suicide, lack of social support, and excess skin. Moreover, special populations of patients may have distinctive psyc...
Approximately 15% of U.S. adults have severe obesity (body mass index; BMI ≥35 kg/m²).  Bariatric surgery, the most effective and enduring treatment, typically results in sustained weight loss and improvement in multiple health domains with low short-term risk. [2–3] Bariatric surgery patients have reduced long-term all-cause mortality when compared to non-bariatri c surgical controls with severe obesity.  However, concerns about suicide risk following bariatric surgery have emerged. [4,5]
Background: While bariatric surgery is a highly effective treatment for severe obesity, numerous studies demonstrate an increased risk of suicide and alcohol use disorder (AUD) in postsurgical patients. Presurgery psychological evaluation is challenging in part because of patients ’ tendency to underreport psychiatric symptoms and substance use prior to surgery. Thus, clinical diagnoses and impairment severity are likely to be underappreciated at that time, preventing identification of and intervention for some high-risk candidates.
Background: Bariatric surgery dramatically improves quality of life in several domains. However, several researchers have reported an increased risk for suicide and self-harm following surgery. Others have failed to find an increased risk, and reasons for the disparity are not obvious. This meta-analysis examined the association between bariatric surgery and suicide or self-harm. It also explored possible moderators of this association. Twenty-eight studies of persons who had undergone bariatric surgery were identified.