title: New-onset substance use disorder after gastric bypass surgery: rates and associated characteristics.
abstract: BACKGROUND
  Substance use disorder (SUD) may develop de novo for a subgroup of weight loss surgery patients, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The present study examined the rate of SUD in a broad sample of RYGB patients and identified associated behavioral and psychological factors.
  
  
  METHODS
  Participants included 143 RYGB patients; the majority were women (n = 120; 83.9 %) and white (n = 135; 94.4 %). Participants completed a web-based survey assessing retrospective accounts of presurgical substance use, eating pathology, family history, and traumatic history, postsurgical substance use, life stressors, and global trait-like measures (emotion dysregulation, impulsivity, sensation-seeking, and coping skills).
  
  
  RESULTS
  A subgroup (n = 28, 19.6 %) of post-RYGB patients met criteria for probable SUD; however, the majority of those who met SUD criteria postsurgery (n = 19, 68 %) did not report a pre-RYGB SUD history. Family history of substance abuse, poor coping skills, and potential life stressors were related to post-RYGB SUD, particularly for the new-onset group. Additionally, the majority of those who met criteria for pre-RYGB SUD (n = 21, 70 %) did not continue to meet SUD criteria following RYGB.
  
  
  CONCLUSIONS
  Findings highlight a subgroup of post-RYGB patients reporting new-onset SUD, which is unexpected among middle-aged women. Importantly, findings also indicate that many patients with presurgical SUD did not relapse postsurgery. Assessing for family history of SUD and coping skills at the presurgical evaluation is recommended. Future research should identify psychological and physiological risk factors for SUD postsurgery and examine protective factors of those who discontinue substance use postsurgery.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, P.O. Box 208098, New Haven, CT, 06520, USA, valentina.ivezaj@yale.edu.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ivezaj
authors.forename: Karen K
authors.initials: KK
authors.lastname: Saules
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Schuh
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D015431:Weight Loss