TY - JOUR
T1 - Suicidal thoughts and behaviors in adolescents who underwent bariatric surgery
AU - Zeller, Meg H.
AU - Reiter-Purtill, Jennifer
AU - Jenkins, Todd M.
AU - Kidwell, Katherine M.
AU - Bensman, Heather E.
AU - Mitchell, James E.
AU - Courcoulas, Anita P.
AU - Inge, Thomas H.
AU - Ley, Sanita L.
AU - Gordon, Kathryn H.
AU - Chaves, Eileen A.
AU - Washington, Gia A.
AU - Austin, Heather M.
AU - Rofey, Dana L.
N1 - Funding Information:
The TeenView ancillary studies (R01 DK080020 and R01 DA033415; PI: Zeller) were conducted in collaboration with the Teen-LABS Consortium. Teen-LABS was funded by cooperative agreements with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), through the following grants: U01 DK072493 , UM1 DK072493 , and UM1 DK095710 (University of Cincinnati). Dr. Kidwell’s effort was supported by a National Institutes of Health postdoctoral training grant ( T32 DK063929 ).
Funding Information:
Participants in the National Institute of Diabetes and Digestive and Kidney Diseases’ Teen Longitudinal Assessment of Bariatric Surgery consortium (Teen-LABS NCT00474318; n = 242, ages 13–19), a multisite prospective observational safety and efficacy study [ 21 ], were invited if eligible (i.e., age ≤18 yr) to participate in a parallel series of independently funded studies (TeenView series) tracking psychosocial health outcomes from presurgery and across the first 4 postsurgery years. The TeenView series recruited a comparator group (“nonsurgical”) of demographically similar adolescents with severe obesity from the 5 Teen-LABS sites. Eligibility criteria and presurgery enrollment for the parent and initial TeenView study were previously described [ 21 , 34 ]. With additional funding from the National Institute on Drug Abuse, TeenView participants retained at year 2, as well Teen-LABS participants initially ineligible for TeenView due to age (i.e., >18 yr at baseline), were approached for TeenView2. Furthermore, participation in TeenView2 was an eligibility criterion for TeenView3 at year 4. Study aims were focused on high-risk behaviors, including suicidal behaviors. Respective study protocols were approved by site institutional review boards. Recruitment/participation information are presented in Fig. 1 .
Funding Information:
Thomas H. Inge has served as a consultant for Standard Bariatrics, UpToDate, and Independent Medical Expert Consulting Services, all unrelated to this project. Anita P. Courcoulas has received research grants from Allurion Inc., unrelated to this project.
Funding Information:
The TeenView ancillary studies (R01 DK080020 and R01 DA033415; PI: Zeller) were conducted in collaboration with the Teen-LABS Consortium. Teen-LABS was funded by cooperative agreements with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), through the following grants: U01 DK072493, UM1 DK072493, and UM1 DK095710 (University of Cincinnati). Dr. Kidwell's effort was supported by a National Institutes of Health postdoctoral training grant (T32 DK063929).
Publisher Copyright:
© 2020 American Society for Bariatric Surgery
PY - 2020/4
Y1 - 2020/4
N2 - 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]age = 17 yr, Mbody mass index[BMI] = 52 kg/m2) and nonsurgical comparators (n = 70; 80% female, 54% white, Mage = 16 yr, MBMI = 47 kg/m2) completed psychometrically sound assessments at presurgery/baseline and postsurgery years 2 and 4 (year 4: n = 117 surgical [MBMI = 38 kg/m2], n = 56 nonsurgical [MBMI = 48 kg/m2]). 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.
AB - 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]age = 17 yr, Mbody mass index[BMI] = 52 kg/m2) and nonsurgical comparators (n = 70; 80% female, 54% white, Mage = 16 yr, MBMI = 47 kg/m2) completed psychometrically sound assessments at presurgery/baseline and postsurgery years 2 and 4 (year 4: n = 117 surgical [MBMI = 38 kg/m2], n = 56 nonsurgical [MBMI = 48 kg/m2]). 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.
KW - Adolescent
KW - Bariatric surgery
KW - Suicidal behavior
KW - Suicide
KW - Young adult
UR - http://www.scopus.com/inward/record.url?scp=85078993192&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078993192&partnerID=8YFLogxK
U2 - 10.1016/j.soard.2019.12.015
DO - 10.1016/j.soard.2019.12.015
M3 - Article
C2 - 32035828
AN - SCOPUS:85078993192
SN - 1550-7289
VL - 16
SP - 568
EP - 580
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 4
ER -