LOS ANGELES – One in five adolescents report poor mental health 2 years after gastric bypass surgery, a Swedish study shows.
“There is an unmet need for psychiatric and psychological treatment in adolescents, and 20% is a much higher figure than you find in adults,” Kajsa Järvholm of Lund University, Sweden, said at Obesity Week 2015.
Ms. Kajsa Järvholm
Notably, weight loss did not differ during follow-up between adolescents with poor mental health (PMH) and those with average or good mental health.
Girls were more likely than were boys to report PMH (14 vs. 2; P = .053), but no significant age difference was found.
Prior research has shown that adolescents seeking bariatric surgery have impaired mental health compared with population norms, but most adolescents experience an improvement after surgery.
A recent systematic review of psychological and social outcomes in adolescents undergoing bariatric surgery found overall quality of life improved after surgery, regardless of the surgical type, with peak improvement at months 6 to 12 (Clin Obes. 2015 Nov. 6. doi: 10.1111/cob.12119).
The current study involved 82 adolescents who were part of the larger Adolescent Morbid Obesity Surgery (AMOS) study cohort. At the time of surgery, the average age of the patients was 16.8 years and the average body mass index was 45.4 kg/m2. Two-thirds (67%) were girls.
The adolescents were assessed by self-report questionnaires at baseline, 1 year, and 2 years after laparoscopic bariatric surgery. Standardized cutoffs on two different variables, depression and obesity-related problems, were used to classify adolescents as having a PMH or average and good mental health 2 years after surgery.
Adolescents with PMH at 2 years post surgery reported significantly more symptoms of anxiety (P = .004) and depression (P = .028) already before surgery, Ms. Järvholm said.
One year after surgery, more differences were observed. Adolescents with PMH, in addition to reporting more symptoms of anxiety (P less than .0001) and depression (P = .003), also reported more anger (P = .005) and obesity-related problems (P = .006) than did adolescents with an average or good mental health.
No differences were seen at this time in self-concept or disruptive behavior, she said.
Two years after surgery, all measured aspects of mental health were worse in adolescents with PMH (all P values less than .0001), Ms. Järvholm said.
“Preoperative identification is difficult since most variables do not differ between groups, but we should take extra care with adolescents with more anxiety and more depression already before surgery,” she said at the meeting, presented by the Obesity Society and American Society for Metabolic and Bariatric Surgery.