Suicidal Thoughts and Behaviors in Adolescents Who Underwent Bariatric surgery

Overview

Journal Surg Obes Relat Dis

Publisher Elsevier

Specialty Endocrinology

Date 2020 Feb 10

PMID 32035828

Citations 8

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

Affiliations

Soon will be listed here.

Abstract

Background: Extant literature warns of elevated suicide risks in adults postbariatric surgery, making understanding risks for adolescent patients imperative.

Objectives: To examine prevalence and predictors/correlates of suicidal thoughts and behaviors (STBs) in adolescents with severe obesity who did/did not undergo bariatric surgery from presurgery/baseline to 4 years postsurgery.

Setting: Five academic medical centers.

Methods: Using a prospective observational design, surgical adolescents (n = 153; 79% female, 65% white, mean [M] = 17 yr, M = 52 kg/m) and nonsurgical comparators (n = 70; 80% female, 54% white, M = 16 yr, M = 47 kg/m) completed psychometrically sound assessments at presurgery/baseline and postsurgery years 2 and 4 (year 4: n = 117 surgical [M = 38 kg/m], n = 56 nonsurgical [M = 48 kg/m]).

Results: For the surgical group, rates of STBs were low (year 2 [1.3%-4.6%]; year 4 [2.6%-7.9%], similar to national base rates. Groups did not differ on a year 4 postsurgical STBs (post-STBs) composite (post-STBs: ideation/plan/attempt; n = 18 surgical [16%], n = 10 nonsurgical [18%]; odds ratio = .95, P = .90). For the surgical group, predictors/correlates identified within the broader suicide literature (e.g., psychopathology [P < .01], victimization [P < .05], dysregulation [P < .001], drug use [P < .05], and knowing an attemptor/completer [P < .001]) were significantly associated with post-STBs. Surgery-specific factors (e.g., percent weight loss, weight satisfaction) were nonsignificant. Of those reporting a lifetime attempt history at year 4, only a minority (4/13 surgical, 3/9 nonsurgical) reported a first attempt during the study period. Of 3 decedents (2 surgical, 1 nonsurgical), none were confirmed suicides.

Conclusions: The present study indicates that undergoing bariatric surgery in adolescence does not heighten (or lower) risk of STB engagement across the initial 4 years after surgery. Suicide risks present before surgery persisted, and also newly emerged in a subgroup with poorer psychosocial health.

Citing Articles

Psychosocial outcomes after adolescent metabolic and bariatric surgery: a narrative review of the literature.

Boles R, Moore J Surg Obes Relat Dis. 2024; 21(1):16-23.

PMID: 39379258 PMC: 11645231. DOI: 10.1016/j.soard.2024.09.003.

Prevalence of mental disorders in patients with pathological obesity selected for bariatric surgery in the KOS-BAR nationwide multi-centre pilot programme - a preliminary report.

Herstowska M, Przygocka-Pieniazek A, Grabowski K, Kaska L Wideochir Inne Tech Maloinwazyjne. 2023; 18(3):502-509.

PMID: 37868291 PMC: 10585463. DOI: 10.5114/wiitm.2023.128910.

Trajectories of Psychopathology and Dysregulation 2-4 Years following Adolescent Bariatric Surgery.

Bejarano C, Gowey M, Reiter-Purtill J, Ley S, Mitchell J, Zeller M J Pediatr Psychol. 2023; 48(5):479-489.

PMID: 36898044 PMC: 10199728. DOI: 10.1093/jpepsy/jsad009.

Ethics of Bariatric Surgery in Adolescence and Its Implications for Clinical Practice.

Martinelli V, Singh S, Politi P, Caccialanza R, Peri A, Pietrabissa A Int J Environ Res Public Health. 2023; 20(2).

PMID: 36673981 PMC: 9859476. DOI: 10.3390/ijerph20021232.

Marijuana, e-cigarette, and tobacco product use in young adults who underwent pediatric bariatric surgery.

Zeller M, Strong H, Reiter-Purtill J, Jenkins T, Mitchell J, Michalsky M Surg Obes Relat Dis. 2022; 19(5):512-521.

PMID: 36567232 PMC: 10461174. DOI: 10.1016/j.soard.2022.11.008.

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