Bariatric surgery linked to higher suicide risk

12 October 2015

Patients who had undergone gastric bypass surgery ran a higher risk of self-harm than before the surgery, according to a new longitudinal cohort analysis.

Bariatric surgery known as gastric bypass, helps patients shed excess pounds by reducing stomach capacity from about three pints to the size of a shot glass.

Researchers led by Junaid Bhatti, PhD, at the Sunnybrook Research Institute in Toronto, studied 8,814 women, 81 per cent of them women, and found that self-harm emergencies were up 2.33 per 1,000 patient years before surgery to 3.63 after surgery.

Post-surgery emergencies were highest in patients over 35, according to the authors, who published their results in JAMA Surgery.

The study "underscores the unique vulnerability of patients undergoing bariatric surgery and forces us to look closely at why suicide rates are more than four times higher in these patients than the general population," wrote Amir Ghaferi, MD, and Carol Lindsay-Westphal, PhD, both at the University of Michigan, wrote in an accompanying editorial. "Bariatric surgery is more than just an operation -- it is time we recognize and treat it is as such."

The first three years after surgery saw, 111 patients receive emergency care for self-inflicted injuries, or roughly 1 per cent of people in the study. While small, the risk of these emergencies was 54 per cent higher following the surgery than before.

''Long-term postoperative follow-up for bariatric patients is not ideal,'' said Ghaferi.

''This study should not dissuade patients with mental-health problems from seeking bariatric surgery,'' Ghaferi added. Rather, it should encourage health-care providers to target these patients for improved follow-up care, he said.

The current study found almost 3 in 4 of the self-inflicted injuries were identified as intentional drug overdoses.

Most of the time, the patients who were involved in such acts had been diagnosed with a mental-health disorder at some point in the five years preceding surgery.


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