Suicide, Self-harm, and Depression After Gastric Bypass Surgery: A Nationwide Cohort Study

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Lagerros, Ylva TrolleKarolinska Institutet (author)

Suicide, Self-harm, and Depression After Gastric Bypass Surgery : A Nationwide Cohort Study

Article/chapterEnglish2017

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2017
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LIBRIS-ID:oai:DiVA.org:uu-308552
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308552URI
https://doi.org/10.1097/SLA.0000000000001884DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:135013326URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:art swepub-publicationtype

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OBJECTIVE: The aim of this study was to examine risk of self-harm, hospitalization for depression and death by suicide after gastric bypass surgery (GBP).SUMMARY OF BACKGROUND DATA: Concerns regarding severe adverse psychiatric outcomes after GBP have been raised.METHODS: This nationwide, longitudinal, self-matched cohort encompassed 22,539 patients who underwent GBP during 2008 to 2012. They were identified through the Swedish National Patient Register, the Prescribed Drug Register, and the Causes of Death Register. Follow-up time was up to 2 years. Main outcome measures were hazard ratios (HRs) for post-surgery self-harm or hospitalization for depression in patients with presurgery self-harm and/or depression compared to patients without this exposure; and standardized mortality ratio (SMR) for suicide post-surgery.RESULTS: A diagnosis of self-harm in the 2 years preceding surgery was associated with an HR of 36.6 (95% confidence interval [CI] 25.5-52.4) for self-harm during the 2 years of follow up, compared to GBP patients who had no self-harm diagnosis before surgery. Patients with a diagnosis of depression preceding GBP surgery had an HR of 52.3 (95% CI 30.6-89.2) for hospitalization owing to depression after GBP, compared to GBP patients without a previous diagnosis of depression. The SMR for suicide after GBP was increased among females (n = 13), 4.50 (95% CI 2.50-7.50). The SMR among males (n = 4), was 1.71 (95% CI 0.54-4.12).CONCLUSIONS: The increased risk of post-surgery self-harm and hospitalization for depression is mainly attributable to patients who have a diagnosis of self-harm or depression before surgery. Raised awareness is needed to identify vulnerable patients with history of self-harm or depression, which may be in need of psychiatric support after GBP.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Gastroenterologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Gastroenterology and Hepatology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
bariatric surgery
depression
epidemiology
obesity
psychiatric disorders
self-injurious behavior
suicide

Added entries (persons, corporate bodies, meetings, titles ...)

Brandt, LenaKarolinska Institutet (author)
Hedberg, JakobUppsala universitet,Gastrointestinalkirurgi(Swepub:uu)jakhe890 (author)
Sundbom, MagnusUppsala universitet,Gastrointestinalkirurgi(Swepub:uu)magsundb (author)
Bodén, RobertKarolinska Institutet,Uppsala universitet,Psykiatri, Akademiska sjukhuset,Karolinska Inst, Dept Med, Clin Epidemiol Unit, Stockholm, Sweden(Swepub:uu)robod677 (author)
Karolinska InstitutetGastrointestinalkirurgi (creator_code:org_t)

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In:Annals of Surgery265:2, s. 235-2430003-49321528-1140

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By the author/editor: Lagerros, Ylva T ...; Brandt, Lena; Hedberg, Jakob; Sundbom, Magnus; Bodén, Robert

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Gastroenterology ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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