Alcohol and substance abuse, depression and suicide attempts after Roux-en-Y gastric bypass surgery
Background Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population‐based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted s...
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| Published in | British journal of surgery Vol. 103; no. 10; pp. 1336 - 1342 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Chichester, UK
John Wiley & Sons, Ltd
01.09.2016
Oxford University Press |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Background
Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population‐based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux‐en‐Y gastric bypass (RYGB).
Methods
All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age‐matched, non‐obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used.
Results
Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non‐obese population was 2·85 (95 per cent c.i. 2·40 to 3·39).
Conclusion
Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non‐obese general population cohort.
Does not fix mental health problems |
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| AbstractList | Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB).
All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used.
Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2·85 (95 per cent c.i. 2·40 to 3·39).
Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort. Background Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population‐based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux‐en‐Y gastric bypass (RYGB). Methods All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age‐matched, non‐obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used. Results Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non‐obese population was 2·85 (95 per cent c.i. 2·40 to 3·39). Conclusion Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non‐obese general population cohort. Does not fix mental health problems Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB).BACKGROUNDSmall studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB).All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used.METHODSAll patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used.Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2·85 (95 per cent c.i. 2·40 to 3·39).RESULTSBefore RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2·85 (95 per cent c.i. 2·40 to 3·39).Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort.CONCLUSIONPatients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort. Background Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB). Methods All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used. Results Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2·85 (95 per cent c.i. 2·40 to 3·39). Conclusion Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort. Does not fix mental health problems Background: Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This population-based cohort study aimed to assess the incidence of treatment for alcohol and substance use disorders, depression and attempted suicide after primary Roux-en-Y gastric bypass (RYGB). Methods: All patients who underwent primary RYGB in Sweden between 2001 and 2010 were included. Incidence of hospital admission for alcohol and substance use disorders, depression and suicide attempt was measured, along with the number of drugs prescribed. This cohort was compared with a large age-matched, non-obese reference cohort based on the Swedish population. Inpatient care and prescribed drugs registers were used. Results: Before RYGB surgery, women, but not men, were at higher risk of being diagnosed with alcohol and substance use disorder compared with the reference cohort. After surgery, this was the case for both sexes. The risk of being diagnosed and treated for depression remained raised after surgery. Suicide attempts were significantly increased after RYGB. The adjusted hazard ratio for attempted suicide in the RYGB cohort after surgery compared with the general non-obese population was 2.85 (95 per cent c.i. 2.40 to 3.39). Conclusion: Patients who have undergone RYGB are at an increased risk of being diagnosed with alcohol and substance use, with an increased rate of attempted suicide compared with a non-obese general population cohort. |
| Author | Backman, O. Stockeld, D. Marsk, R. Rasmussen, F. Näslund, E. |
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Prevalence of alcohol use disorders before and after bariatric surgery. JAMA 2012; 307: 2516-2525. Ostlund MP, Backman O, Marsk R, Stockeld D, Lagergren J, Rasmussen F et al. Increased admission for alcohol dependence after gastric bypass surgery compared with restrictive bariatric surgery. JAMA Surg 2013; 148: 374-377. Booth H, Khan O, Prevost AT, Reddy M, Charlton J, Gulliford MC; Kings Bariatric Surgery Study Group. Impact of bariatric surgery on clinical depression. Interrupted time series study with matched controls. J Affect Disord 2015; 174: 644-649. Karlsson J, Taft C, Ryden A, Sjostrom L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond) 2007; 31: 1248-1261. Mitchell JE, Crosby R, de Zwaan M, Engel S, Roerig J, Steffen K et al. Possible risk factors for increased suicide following bariatric surgery. Obesity (Silver Spring) 2013; 21: 665-672. 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| References_xml | – reference: Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C et al. External review and validation of the Swedish national inpatient register. BMC Public Health 2011; 11: 450. – reference: de Zwaan M, Hilbert A, Swan-Kremeier L, Simonich H, Lancaster K, Howell LM et al. Comprehensive interview assessment of eating behavior 18-35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis 2010; 6: 79-85. – reference: King WC, Chen JY, Mitchell JE, Kalarchian MA, Steffen KJ, Engel SG et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA 2012; 307: 2516-2525. – reference: Klockhoff H, Näslund I, Jones AW. Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery. Br J Clin Pharmacol 2002; 54: 587-591. – reference: Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007; 357: 753-761. – reference: Woodard GA, Downey J, Hernandez-Boussard T, Morton JM. Impaired alcohol metabolism after gastric bypass surgery: a case-crossover trial. J Am Coll Surg 2011; 212: 209-214. – reference: Adams TD, Mehta TS, Davidson LE, Hunt SC. All-cause and cause-specific mortality associated with bariatric surgery: a review. Curr Atheroscler Rep 2015; 17: 74. – reference: Conason A, Teixeira J, Hsu CH, Puma L, Knafo D, Geliebter A. Substance use following bariatric weight loss surgery. JAMA Surg 2013; 148: 145-150. – reference: Wee CC, Mukamal KJ, Huskey KW, Davis RB, Colten ME, Bolcic-Jankovic D et al. High-risk alcohol use after weight loss surgery. Surg Obes Relat Dis 2014; 10: 508-513. – reference: Svensson PA, Anveden Å, Romeo S, Peltonen M, Ahlin S, Burza MA et al. Alcohol consumption and alcohol problems after bariatric surgery in the Swedish obese subjects study. Obesity (Silver Spring) 2013; 21: 2444-2451. – reference: Heinberg LJ, Ashton K, Coughlin J. Alcohol and bariatric surgery: review and suggested recommendations for assessment and management. Surg Obes Relat Dis 2012; 8: 357-363. – reference: Mitchell JE, King WC, Chen JY, Devlin MJ, Flum D, Garcia L et al. Course of depressive symptoms and treatment in the Longitudinal Assessment of Bariatric Surgery (LABS-2) study. Obesity (Silver Spring) 2014; 22: 1799-1806. – reference: Mitchell JE, Steffen K, Engel S, King WC, Chen JY, Winters K et al. Addictive disorders after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2015; 11: 897-905. – reference: Ostlund MP, Backman O, Marsk R, Stockeld D, Lagergren J, Rasmussen F et al. Increased admission for alcohol dependence after gastric bypass surgery compared with restrictive bariatric surgery. JAMA Surg 2013; 148: 374-377. – reference: Mitchell JE, Selzer F, Kalarchian MA, Devlin MJ, Strain GW, Elder KA et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis 2012; 8: 533-541. – reference: Kudsi OY, Huskey K, Grove S, Blackburn G, Jones DB, Wee CC. Prevalence of preoperative alcohol abuse among patients seeking weight-loss surgery. Surg Endosc 2013; 27: 1093-1097. – reference: Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med 2013; 273: 219-234. – reference: Tindle HA, Omalu B, Courcoulas A, Marcus M, Hammers J, Kuller LH. Risk of suicide after long-term follow-up from bariatric surgery. Am J Med 2010; 123: 1036-1042. – reference: de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: a meta-analysis of community-based studies. Psychiatry Res 2010; 178: 230-235. – reference: Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G et al. 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Am J Psychiatry 2000; 157: 1925-1932. – volume: 21 start-page: 665 year: 2013 end-page: 672 publication-title: Obesity (Silver Spring) – volume: 6 start-page: 79 year: 2010 end-page: 85 article-title: Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity publication-title: Surg Obes Relat Dis – volume: 212 start-page: 209 year: 2011 end-page: 214 article-title: Impaired alcohol metabolism after gastric bypass surgery: a case‐crossover trial publication-title: J Am Coll Surg – volume: 357 start-page: 753 year: 2007 end-page: 761 article-title: Long‐term mortality after gastric bypass surgery publication-title: N Engl J Med – volume: 123 start-page: 1036 year: 2010 end-page: 1042 article-title: Risk of suicide after long‐term follow‐up from bariatric surgery publication-title: Am J Med – volume: 11 start-page: 450 year: 2011 article-title: External review and validation of the Swedish national inpatient register publication-title: BMC Public Health – volume: 10 start-page: 508 year: 2014 end-page: 513 article-title: High‐risk alcohol use after weight loss surgery publication-title: Surg Obes Relat Dis – volume: 22 start-page: 1799 year: 2014 end-page: 1806 article-title: Course of depressive symptoms and treatment in the Longitudinal Assessment of Bariatric Surgery (LABS‐2) study publication-title: Obesity (Silver Spring) – volume: 215 start-page: 475 year: 2012 end-page: 479 article-title: Normal alcohol metabolism after gastric banding and sleeve gastrectomy: a case‐cross‐over trial publication-title: J Am Coll Surg – volume: 8 start-page: 533 year: 2012 end-page: 541 article-title: Psychopathology before surgery in the longitudinal assessment of bariatric surgery‐3 (LABS‐3) psychosocial study publication-title: Surg Obes Relat Dis – volume: 17 start-page: 74 year: 2015 article-title: All‐cause and cause‐specific mortality associated with bariatric surgery: a review publication-title: Curr Atheroscler Rep – volume: 307 start-page: 2516 year: 2012 end-page: 2525 article-title: Prevalence of alcohol use disorders before and after bariatric surgery publication-title: JAMA – volume: 11 start-page: 897 year: 2015 end-page: 905 article-title: Addictive disorders after Roux‐en‐ gastric bypass publication-title: Surg Obes Relat Dis – volume: 8 start-page: 357 year: 2012 end-page: 363 article-title: Alcohol and bariatric surgery: review and suggested recommendations for assessment and management publication-title: Surg Obes Relat Dis – volume: 20 start-page: 744 year: 2010 end-page: 748 article-title: Alcohol absorption modification after a laparoscopic sleeve gastrectomy due to obesity publication-title: Obes Surg – volume: 148 start-page: 145 year: 2013 end-page: 150 article-title: Substance use following bariatric weight loss surgery publication-title: JAMA Surg – volume: 178 start-page: 230 year: 2010 end-page: 235 article-title: Depression and obesity: a meta‐analysis of community‐based studies publication-title: Psychiatry Res – volume: 174 start-page: 644 year: 2015 end-page: 649 article-title: Impact of bariatric surgery on clinical depression. Interrupted time series study with matched controls publication-title: J Affect Disord – volume: 31 start-page: 1248 year: 2007 end-page: 1261 article-title: Ten‐year trends in health‐related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study publication-title: Int J Obes (Lond) – volume: 54 start-page: 587 year: 2002 end-page: 591 article-title: Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery publication-title: Br J Clin Pharmacol – volume: 157 start-page: 1925 year: 2000 end-page: 1932 article-title: Affective disorders and suicide risk: a reexamination publication-title: Am J Psychiatry – volume: 27 start-page: 1093 year: 2013 end-page: 1097 article-title: Prevalence of preoperative alcohol abuse among patients seeking weight‐loss surgery publication-title: Surg Endosc – volume: 273 start-page: 219 year: 2013 end-page: 234 article-title: Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery publication-title: J Intern Med – volume: 21 start-page: 2444 year: 2013 end-page: 2451 article-title: Alcohol consumption and alcohol problems after bariatric surgery in the Swedish obese subjects study publication-title: Obesity (Silver Spring) – volume: 148 start-page: 374 year: 2013 end-page: 377 article-title: Increased admission for alcohol dependence after gastric bypass surgery compared with restrictive bariatric surgery publication-title: JAMA Surg – volume: 22 start-page: 530 year: 2012 end-page: 535 article-title: Investigation of antidepressant medication usage after bariatric surgery publication-title: Obes Surg – volume: 347 start-page: f5934 year: 2013 article-title: Bariatric surgery non‐surgical treatment for obesity: a systematic review and meta‐analysis of randomised controlled trials publication-title: BMJ – volume: 8 year: 2013 article-title: Roux‐en‐ gastric bypass increases intravenous ethanol self‐administration in dietary obese rats publication-title: PLoS One |
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Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This... Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This... Background Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders. This... Background: Small studies suggest that subjects who have undergone bariatric surgery are at increased risk of suicide, alcohol and substance use disorders.... |
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| SubjectTerms | Adolescent Adult Aged Aged, 80 and over Alcohol-Related Disorders - diagnosis Alcohol-Related Disorders - epidemiology Alcohol-Related Disorders - etiology Depression - diagnosis Depression - epidemiology Depression - etiology Female Follow-Up Studies Gastric Bypass - psychology Hospitalization - statistics & numerical data Humans Incidence Male Middle Aged Obesity - psychology Obesity - surgery Postoperative Complications - diagnosis Postoperative Complications - epidemiology Postoperative Complications - therapy Registries Substance-Related Disorders - diagnosis Substance-Related Disorders - epidemiology Substance-Related Disorders - etiology Suicide, Attempted - statistics & numerical data Sweden - epidemiology Young Adult |
| Title | Alcohol and substance abuse, depression and suicide attempts after Roux-en-Y gastric bypass surgery |
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