Mental health service use up after bariatric surgery

(HealthDay)—There is an increase in mental health service presentations after bariatric surgery, according to a study published online Sept. 25 in JAMA Psychiatry.

David J.R. Morgan, M.B.B.S., from the St. John of God Subiaco Hospital in Perth, Australia, and colleagues examined the correlation of bariatric surgery with the incidence of outpatient, emergency department, and inpatient mental health service use in a longitudinal cohort study. Data were reviewed for all 24,766 patients undergoing index bariatric surgery over a 10-year period (January 2007 through December 2016).

The researchers found that 16.1 percent of patients used at least one mental health service, with 35.2, 25.8, and 39 percent presenting only before surgery, before and after surgery, and only after surgery, respectively. Psychiatric illness presentations increased after bariatric surgery (outpatient clinic attendance, emergency department attendance, psychiatric hospitalization: incidence rate ratios [IRRs], 2.3, 3.0, 3.0, respectively). In addition, deliberate self-harm presentations to an emergency department increased fivefold after surgery (IRR, 4.7); 9.6 percent of postoperative deaths were due to suicide. The most important factors associated with subsequent mental health presentation after surgery were complications after bariatric surgery requiring further surgical intervention, and a history of mental health service provision before surgery.

"Our findings question the hypothesis that weight reduction by bariatric surgery will improve mental health in patients with obesity," the authors write.

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