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#JamesDonaldsononMentalHealth – #MentalHealth Service Use Appears To Increase After #Bariatric #Surgery

Morgan DJR, et al. JAMA Psychiatry. 2019;doi:10.1001/jamapsychiatry.2019.2741.

Over an average follow-up of 5 years, one in 10 patients who underwent bariatric surgery used #mentalhealth service afterwards, according to findings published in JAMA Psychiatry.

“Several recent studies have highlighted a concern that bariatric surgery may exacerbate psychiatric conditions, especially deliberate self-harm and suicide,” David J. R. Morgan, MBBS, of St. John of God Subiaco Hospital in Perth, Australia, and colleagues wrote. “In response to this, major professional #bariatric societies currently recommend that potential surgical candidates should have either no active severe [psychopathology] or drug dependency problems and/or have undergone psychological assessment before surgery.”

#JamesDonaldsononMentalHealth – 

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.


Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.


Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle



 

Researchers conducted a longitudinal cohort study to better understand the link between #bariatricsurgery and broader #mentalhealth outcomes, such as the incidence of outpatient, ED and inpatient #mentalhealth service use. They examined data on patients undergoing their first #bariatricsurgery in Western Australia over a 10-year period to determine the incidence and predictors for #mentalhealth presentations, deliberate self-harm and #suicide associated with the timing of #bariatricsurgery.

Overall, 24,766 patients (77.3% women) underwent #bariatricsurgery. In total, 3,979 patients (16.1%) used at least one #mentalhealth service. Of these, 1,401 patients (35.2%) presented only before surgery, 1,025 (25.8%) presented both before and after surgery, and 1,550 patients (39%) presented only after surgery.

After #bariatricsurgery, Morgan and colleagues reported an increase in outpatient clinic attendance (incidence rate ratio [IRR] = 2.3; 95% CI, 2.3-2.4), ED attendance (IRR = 3; 95% CI, 2.8-3.2) and psychiatric hospitalization (IRR = 3; 95% CI, 2.8-3.1).

The results also showed that presentations to the ED due to deliberate self-harm increased nearly 5-fold after surgery (IRR = 4.7; 95% CI, 3.8-5.7). Overall, #suicides accounted for about 10% of post-operative deaths.

Some risk factors of self-harm or #suicidalideation after first #bariatric surgery included younger age; higher socioeconomic status; self-harm, #suicidalideation, mental disorders due to psychoactive substance abuse, or mood disorders before their surgery. Complications after index surgery requiring further surgical intervention were also associated with later #mentalhealth presentations.

“Our findings question the hypothesis that weight reduction by #bariatric surgery will improve #mentalhealth in patients with obesity,” the investigators wrote. “Whether using a preoperative psychological assessment, as recommended by the current guidelines, can identify those at risk and improve their mental health outcomes, to our knowledge, remains scientifically unproven.” – by Savannah Demko

Photo by Павел Сорокин on Pexels.com

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