Kathryn H Gordon1, Wendy C King2, Gretchen E White2, Steven H Belle2, Anita P Courcoulas3, Faith E Ebel4, Scott G Engel5, Dave R Flum6, Marcelo W Hinojosa6, Alfons Pomp4, Walter J Pories7, Dino Spaniolas7, Bruce M Wolfe8, Susan Z Yanovski9, James E Mitchell5. 1. Neuropsychiatric Research Institute, Fargo, North Dakota; Department of Psychology, North Dakota State University, Fargo, North Dakota. Electronic address: kathryn.gordon@ndsu.edu. 2. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania. 3. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 4. Weill Cornell Medicine, New York, New York. 5. Neuropsychiatric Research Institute, Fargo, North Dakota. 6. Department of Surgery, University of Washington, Seattle, Washington. 7. Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina. 8. Department of Surgery, Oregon Health Sciences University, Portland, Oregon. 9. Office of Obesity Research, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
Abstract
BACKGROUND: Past research suggests self-harm/suicidality are more common among adults who have undergone bariatric surgery than the general population. OBJECTIVES: To compare prevalence of self-harm/suicidal ideation over time and identify presurgery risk factors for postsurgery self-harm/suicidal ideation. SETTING: The Longitudinal Assessment of Bariatric Surgery-2 is a cohort study with presurgery and annual postsurgery assessments conducted at 10 U.S. hospitals. METHODS: Adults with severe obesity undergoing bariatric surgery between March 2006 and April 2009 (n = 2458). Five-year follow-up is reported. Self-reported history of suicidality assessed retrospectively via the Suicide Behavior Questionnaire-Revised (SBQ-R) and self-reported self-harm/suicidal ideation assessed prospectively via the Beck Depression Inventory-Version 1 (BDI-1). RESULTS: The SBQ-R was completed by 1540 participants; 2217 completed the BDI-1 pre- and postsurgery. Over 75% of participants were female, with a median age of 46 years and body mass index of 45.9 kg/m2. Approximately one fourth of participants (395/1534) reported a presurgery history of suicidal thoughts or behavior (SBQ-R). The prevalence of self-harm/suicidal ideation (BDI-1) was 5.3% (95% confidence interval [CI], 3.7-6.8) presurgery and 3.8% (95% CI, 2.5-5.1) at year 1 postsurgery (P = .06). Prevalence increased over time postsurgery to 6.6% (95% CI, 4.6-8.6) at year 5 (P = .001) but was not significantly different than presurgery (P = .12). CONCLUSIONS: A large cohort of adults with severe obesity who underwent bariatric surgery had a prevalence of self-harm/suicidal ideation that may have decreased in the first postoperative year but increased over time to presurgery levels, suggesting screening for self-harm/suicidality is warranted throughout long-term postoperative care. Several risk factors were identified that may help with enhanced monitoring.
BACKGROUND: Past research suggests self-harm/suicidality are more common among adults who have undergone bariatric surgery than the general population. OBJECTIVES: To compare prevalence of self-harm/suicidal ideation over time and identify presurgery risk factors for postsurgery self-harm/suicidal ideation. SETTING: The Longitudinal Assessment of Bariatric Surgery-2 is a cohort study with presurgery and annual postsurgery assessments conducted at 10 U.S. hospitals. METHODS: Adults with severe obesity undergoing bariatric surgery between March 2006 and April 2009 (n = 2458). Five-year follow-up is reported. Self-reported history of suicidality assessed retrospectively via the Suicide Behavior Questionnaire-Revised (SBQ-R) and self-reported self-harm/suicidal ideation assessed prospectively via the Beck Depression Inventory-Version 1 (BDI-1). RESULTS: The SBQ-R was completed by 1540 participants; 2217 completed the BDI-1 pre- and postsurgery. Over 75% of participants were female, with a median age of 46 years and body mass index of 45.9 kg/m2. Approximately one fourth of participants (395/1534) reported a presurgery history of suicidal thoughts or behavior (SBQ-R). The prevalence of self-harm/suicidal ideation (BDI-1) was 5.3% (95% confidence interval [CI], 3.7-6.8) presurgery and 3.8% (95% CI, 2.5-5.1) at year 1 postsurgery (P = .06). Prevalence increased over time postsurgery to 6.6% (95% CI, 4.6-8.6) at year 5 (P = .001) but was not significantly different than presurgery (P = .12). CONCLUSIONS: A large cohort of adults with severe obesity who underwent bariatric surgery had a prevalence of self-harm/suicidal ideation that may have decreased in the first postoperative year but increased over time to presurgery levels, suggesting screening for self-harm/suicidality is warranted throughout long-term postoperative care. Several risk factors were identified that may help with enhanced monitoring.
Authors: Anita P Courcoulas; Wendy C King; Steven H Belle; Paul Berk; David R Flum; Luis Garcia; William Gourash; Mary Horlick; James E Mitchell; Alfons Pomp; Walter J Pories; Jonathan Q Purnell; Ashima Singh; Konstantinos Spaniolas; Richard Thirlby; Bruce M Wolfe; Susan Z Yanovski Journal: JAMA Surg Date: 2018-05-01 Impact factor: 14.766
Authors: James E Mitchell; Ross Crosby; Martina de Zwaan; Scott Engel; James Roerig; Kristine Steffen; Kathryn H Gordon; Trisha Karr; Jason Lavender; Steve Wonderlich Journal: Obesity (Silver Spring) Date: 2013-04 Impact factor: 5.002
Authors: Wendy C King; Jia-Yuh Chen; Steven H Belle; Anita P Courcoulas; Gregory F Dakin; Katherine A Elder; David R Flum; Marcelo W Hinojosa; James E Mitchell; Walter J Pories; Bruce M Wolfe; Susan Z Yanovski Journal: JAMA Date: 2016-04-05 Impact factor: 56.272
Authors: Eunice Y Chen; Karla C Fettich; Megan Tierney; Hakeemah Cummings; Johnny Berona; Jessica Weissman; Amanda Ward; Kara Christensen; Matthew Southward; Kathryn H Gordon; James Mitchell; Emil Coccaro Journal: Suicide Life Threat Behav Date: 2012-09-07
Authors: Meg H Zeller; Jennifer Reiter-Purtill; Todd M Jenkins; Katherine M Kidwell; Heather E Bensman; James E Mitchell; Anita P Courcoulas; Thomas H Inge; Sanita L Ley; Kathryn H Gordon; Eileen A Chaves; Gia A Washington; Heather M Austin; Dana L Rofey Journal: Surg Obes Relat Dis Date: 2019-12-24 Impact factor: 4.734
Authors: Jacob G Mabey; Ronette L Kolotkin; Ross D Crosby; Sheila E Crowell; Steven C Hunt; Lance E Davidson Journal: Surg Obes Relat Dis Date: 2020-08-31 Impact factor: 4.734