TY  - JOUR
PY  - 2015//
TI  - Self-harm emergencies after bariatric surgery: a population-based cohort study
JO  - JAMA surgery
A1  - Bhatti, Junaid A.
A1  - Nathens, Avery B.
A1  - Thiruchelvam, Deva
A1  - Grantcharov, Teodor
A1  - Goldstein, Benjamin I.
A1  - Redelmeier, Donald A.
SP  - 226
EP  - 232
VL  - 151
IS  - 3
N2  - IMPORTANCE: Self-harm behaviors, including suicidal ideation and past suicide attempts, are frequent in bariatric surgery candidates. It is unclear, however, whether these behaviors are mitigated or aggravated by surgery. <br><br>OBJECTIVE: To compare the risk of self-harm behaviors before and after bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS: In this population-based, self-matched, longitudinal cohort analysis, we studied 8815 adults from Ontario, Canada, who underwent bariatric surgery between April 1, 2006, and March 31, 2011. Follow-up for each patient was 3 years prior to surgery and 3 years after surgery. MAIN OUTCOMES AND MEASURES: Self-harm emergencies 3 years before and after surgery. <br><br>RESULTS: The cohort included 8815 patients of whom 7176 (81.4%) were women, 7063 (80.1%) were 35 years or older, and 8681 (98.5%) were treated with gastric bypass. A total of 111 patients had 158 self-harm emergencies during follow-up. Overall, self-harm emergencies significantly increased after surgery (3.63 per 1000 patient-years) compared with before surgery (2.33 per 1000 patient-years), equaling a rate ratio (RR) of 1.54 (95% CI, RESULTS:  1.03-2.30; P = .007). Self-harm emergencies after surgery were higher than before surgery among patients older than 35 years (RR, 1.76; 95% CI, 1.05-2.94; P =.03), those with a low-income status (RR, 2.09; 95% CI, 1.20-3.65; P =.01), and those living in rural areas (RR, 6.49; 95%  RESULTS: CI, 1.42-29.63; P =.02). The most common self-harm mechanism was an intentional overdose (115 [72.8%]). A total of 147 events (93.0%) occurred in patients diagnosed as having a mental health disorder during the 5 years before the surgery. <br><br>CONCLUSIONS AND RELEVANCE: In this study, the risk of self-harm emergencies increased after bariatric surgery, underscoring the need for screening for suicide risk during follow-up.<p />  <p>Language: en</p>
LA  - en
SN  - 2168-6254
UR  - http://dx.doi.org/10.1001/jamasurg.2015.3414
ID  - ref1
ER  -