Characteristics of Adolescents with Poor Mental Health after Bariatric Surgery

• Published in: Surgery for obesity and related diseases Vol. 12; no. 4; pp. 882 - 890
• Main Authors: Järvholm, Kajsa, M.Sc. psych, Karlsson, Jan, Ph.D, Olbers, Torsten, M.D. Ph.D, Peltonen, Markku, Ph.D, Marcus, Claude, M.D. Ph.D, Dahlgren, Jovanna, M.D. Ph.D, Gronowitz, Eva, Ph.D, Johnsson, Per, Ph.D, Flodmark, Carl-Erik, M.D. Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Adolescent; Adolescents; Anxiety; Anxiety Disorders - etiology; Bariatric surgery; Biomarkers - metabolism; Clinical Medicine; Depression; Depressive Disorder - etiology; depressive symptoms; eating behavior; Emotions; Female; follow-up; Gastric Bypass - adverse effects; Gastric Bypass - psychology; gastric bypass-surgery; Gastroenterology and Hepatology; Health Status; Health-related quality of life; Hospitalization; Humans; Klinisk medicin; Laparoscopy - adverse effects; Laparoscopy - psychology; longitudinal assessment; Male; Medicin och hälsovetenskap; Mental Disorders - etiology; Mental health; metaanalysis; Pediatric Obesity - psychology; Pediatric Obesity - surgery; Postoperative Complications - psychology; Prognosis; psychological outcomes; Psychology; Psykologi; Quality of Life; Samhällsvetenskap; Self Concept; severely obese adolescents; Social Sciences; Suicidal Ideation; Surgery; Sweden; weight-loss; anxiety; health-related quality of life; bariatric surgery; depression; adolescents; mental health; Health-related quality of life; Depression; Anxiety; Adolescents; Bariatric surgery; Mental health
• ISSN: 1550-7289; 1878-7533; 1878-7533
• DOI: 10.1016/j.soard.2016.02.001

Abstract Background About 20% of adolescents demonstrate substantial mental health problems after bariatric surgery. Objectives The aim of this study was to explore differences between adolescents with poor mental health (PMH) two years after surgery and those with average/good mental health (A/GMH). Setting Three university hospitals in Sweden. Methods Mental health and health-related quality of life were assessed in 82 of 88 operated adolescents (mean age: 16.8, 67% girls) at baseline and one and two years after laparoscopic gastric bypass. Possible associations between mental health, weight, and biochemical outcomes were explored. Results Two years after surgery 16 (20%) adolescents were identified as having PMH. More symptoms of anxiety and depression, and worse mental health at baseline significantly predicted PMH two years later. The decline in mental health for the PMH group happened mainly during the second year after surgery. Suicidal ideation was reported in 14% of the total sample two years post-surgery and was more frequent in the PMH group. Weight outcome between groups were comparable at all time-points, and physical health was equally improved two years after surgery. Conclusions Although adolescents with PMH after surgery lose as much weight and have similar improvements in physical health as other adolescents, special attention should be given to adolescents who report mental health problems at baseline and follow-up, especially during the second year after gastric bypass. The high prevalence of suicide ideation in adolescents two years after bariatric surgery is another indication that longer follow-up is necessary.