Risk of Suicide Attempts after WLS article

[Tssiemer1 549]

Sometimes we get sooooo caught up in what we think is a magic cure and when it turns out it doesn't work we can feel hopeless and suicidal like with antidepressants.

I found it fascinating that a lot of people with Schizophrenia with hearing voices will commit suicide after they are medicated due to missing the voices.

Other people antidepressants can clear their minds enough to decide on suicide and make them impulsive.

That's the theory in my field though.

I can totally see someone being so unhappy they think it's related to their weight. They get the surgery and lose weight and are still unhappy. That can definitely lead to suicide.

Edited October 13, 2015 by Tssiemer1

[OKCPirate 5,323]

I have been writing the studies author, here is his response:

Thank you for the clarification.

First of all, I share your concern that the overall benefits of this procedure should not be misinterpreted in media reports and we have tried our best in all interviews that we explain well that this (self-harm) problem concerns a small proportion of bariatric patients, and it can be addressed by a targeted, better follow-up of patients who may need them.

Regarding the comparison, we did not compare the bariatric population (cohort) with any external general population. The statistics that you have mentioned is a descriptive one. It indicates a mental health diagnosis recorded in health databases in the five year prior to the surgery. Of note, up to 10 diagnosis can be recoded per patient, whenever, he or she contacts any provincially funded healthcare provider (mostly physicians). The most patients were diagnosed with anxiety disorder and a proportion with depression.

What we did is that we repeat the analysis per stratum, i.e., by age, gender, income, and mental health strata. We observed similar trends as the main results though some strata showed more increase in events than others.

We are aware of Cleveland clinic study as well as the fact that there are several groups in the US looking into long-term psychosocial consequences of this surgery.

We tried our best to indicate the benefits of the surgery and the accompanied invited commentary from JAMA Surgery also seconds us on this.

- We aim that our findings result in a better acknowledgement and awareness of this issue that touches a small proportion of bariatric patients

Warmest regards,

Junaid

Subject: RE: Your JAMA article/editorial

I saw the difficulty in doing the study. Without significant funding it would be really hard to get a real profile of those who are doing the self-harm. My concern is in the abstract you mentioned 93% of the self harm group already suffered from some form of mental illness. And when compared to the population at large was there a check to see if the populations were similar. Was there demographic analysis of the population that did self-harm besides location, age and sex? For instance income? My concern is that you are probably looking at a specific demographic sub-set which should be compared to a like sub-set, not the population at large. Without it you are creating a new stigma for those of us who have used these procedures. If the media is misinterpreting your study for a cheap headline, well that’s not your fault. Did you all check with the Cleveland Clinic who has been doing some fantastic research on long term results of bariatric surgery?

I appreciate your attention.

[VSGAnn2014 12,992]

I have been writing the studies author, here is his response:

Thank you for the clarification.

First of all, I share your concern that the overall benefits of this procedure should not be misinterpreted in media reports and we have tried our best in all interviews that we explain well that this (self-harm) problem concerns a small proportion of bariatric patients, and it can be addressed by a targeted, better follow-up of patients who may need them.

Regarding the comparison, we did not compare the bariatric population (cohort) with any external general population. The statistics that you have mentioned is a descriptive one. It indicates a mental health diagnosis recorded in health databases in the five year prior to the surgery. Of note, up to 10 diagnosis can be recoded per patient, whenever, he or she contacts any provincially funded healthcare provider (mostly physicians). The most patients were diagnosed with anxiety disorder and a proportion with depression.

What we did is that we repeat the analysis per stratum, i.e., by age, gender, income, and mental health strata. We observed similar trends as the main results though some strata showed more increase in events than others.

We are aware of Cleveland clinic study as well as the fact that there are several groups in the US looking into long-term psychosocial consequences of this surgery.

We tried our best to indicate the benefits of the surgery and the accompanied invited commentary from JAMA Surgery also seconds us on this.

- We aim that our findings result in a better acknowledgement and awareness of this issue that touches a small proportion of bariatric patients

Warmest regards,

Junaid

Subject: RE: Your JAMA article/editorial

I saw the difficulty in doing the study. Without significant funding it would be really hard to get a real profile of those who are doing the self-harm. My concern is in the abstract you mentioned 93% of the self harm group already suffered from some form of mental illness. And when compared to the population at large was there a check to see if the populations were similar. Was there demographic analysis of the population that did self-harm besides location, age and sex? For instance income? My concern is that you are probably looking at a specific demographic sub-set which should be compared to a like sub-set, not the population at large. Without it you are creating a new stigma for those of us who have used these procedures. If the media is misinterpreting your study for a cheap headline, well that’s not your fault. Did you all check with the Cleveland Clinic who has been doing some fantastic research on long term results of bariatric surgery?

I appreciate your attention.

AWESOME, @@OKCPirate !

I swear -- if I were single and your age I would try to date you! But I bet we'd wind up being "just" good friends. You are my kind of person.

Again, so freakin' awesome!

[CowgirlJane 14,259]

I 're-read this thanks to Anne quoting it. The comment about anxiety being the number one mental health issue pre surgery hit home.

I have developed a theory, based on reading these forums plus my own experiences, that anxiety is a common and big issue for the obese.

[OKCPirate 5,323]

@@CowgirlJane - Anxiety and depression are almost the same thing. I think both are common. (Not picking, just my research from dealing with my ex's issues with mental health).