Patients more likely to seek psychiatric help after bariatric surgery

  • Morgan DJR & al.
  • JAMA Psychiatry
  • 25/09/2019

  • Kelli Whitlock Burton
  • Clinical Essentials
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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: style="list-style-type:circle;">
  • 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