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Citation
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Hung A, Maciejewski ML, Berkowitz TSZ, Arterburn DE, Mitchell JE, Bradley KA, Kimbrel NA, Smith VA. Ann. Surg. 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: In a large multi-site cohort of Veterans who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), we compared the five-year suicidal ideation and attempt rates with matched non-surgical controls. SUMMARY BACKGROUND DATA: Bariatric surgery has significant health benefits but has also been associated with adverse mental health outcomes.
METHODS: Five year rates of suicidal ideation and suicide attempts of Veterans who underwent RYGB or LSG from FY2000-2016 to matched non-surgical controls using sequential stratification using cumulative incidence functions (ideation cohort n=38,199; attempt cohort n=38,661 after excluding patients with past-year outcome events). Adjusted differences in suicidal ideation and suicide attempts were estimated using a Cox regression with a robust sandwich variance estimator.
RESULTS: In the matched cohorts for suicidal ideation analyses, the mean age was 53.47 years and the majority were males (78.7%) and white (77.7%). Over 40% were treated for depression (41.8%), had a non-recent depression diagnosis (40.9%), and 4.1% had past suicidal ideation or suicide attempts more than one year prior to index. Characteristics of the suicide attempt cohort were similar. Regression results found that risk of suicidal ideation was significantly higher for surgical patients (adjusted hazard ratio (aHR)=1.21, 95% confidence interval (CI): 1.03-1.41), as was risk of suicide attempt (aHR=1.62, 95% CI: 1.22-2.15).
CONCLUSIONS: Bariatric surgery appears to be associated with a greater risk of suicidal ideation and attempts than non-surgical treatment of patients with severe obesity, suggesting that patients need careful monitoring for suicidal ideation and additional psychological support after bariatric surgery.
Language: en |