title: Change in consumption patterns for treatment-seeking patients with alcohol use disorder post-bariatric surgery.
abstract: OBJECTIVE
  The aim of this study is to describe the clinical phenotype of alcohol use disorder (AUD) treatment-seeking patients with Roux-en-Y Gastric Bypass Surgery (RYGB) history; and to compare it to AUD obese non-RYGB controls.
  
  
  METHODS
  Retrospective study of electronic medical records for all patients 30-60years treated at the Mayo Clinic Addiction Treatment Program, between June, 2004 and July, 2012. Comparisons were performed with consumption patterns pre-RYGB and at time of treatment; excluding patients with AUD treatments pre-RYGB.
  
  
  RESULTS
  Forty-one out of 823 patients had a RYGB history (4.9%); 122 controls were selected. Compared to controls, the RYGB group had significantly more females [n=29 (70.7%) vs. n=35 (28.7%) p<0.0001]; and met AUD criteria at a significantly earlier age (19.1±0.4 vs. 25.0±1years old, p=0.002). On average, RYGB patients reported resuming alcohol consumption 1.4±0.2years post-surgery, meeting criteria for AUD at 3.1±0.5years and seeking treatment at 5.4±0.3years postoperatively. Pre-surgical drinks per day were significantly fewer compared to post-surgical consumption [2.5±0.4 vs. 8.1±1.3, p=0.009]. Prior to admission, RYGB patients reported fewer drinking days per week vs. controls (4.7±0.3 vs. 5.5±1.8days, p=0.02). Neither RYGB, gender, age nor BMI was associated with differential drinking patterns.
  
  
  CONCLUSIONS
  The results of this study suggest that some patients develop progressive AUD several years following RYGB. This observation has important clinical implications, calling for AUD-preventive measures following RYGB. Further large-scale longitudinal studies are needed to clarify the association between RYGB and AUD onset.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States; Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.
authors.forename: Alfredo B
authors.initials: AB
authors.lastname: Cuellar-Barboza
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frye
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Karen
authors.initials: K
authors.lastname: Grothe
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States; Facultad de Medicina, Departamento de Psiquiatría, Universidad de los Andes, Santiago, Chile.
authors.forename: Miguel L
authors.initials: ML
authors.lastname: Prieto
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Terry D
authors.initials: TD
authors.lastname: Schneekloth
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Larissa L
authors.initials: LL
authors.lastname: Loukianova
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Hall-Flavin
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Karpyak
authors.affiliation: Department of Pharmacology, The American University of the Caribbean School of Medicine, United States.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Miller
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States. Electronic address: Abulseoud.osama@mayo.edu.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Abulseoud
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis; D018450:Disease Progression; D057286:Electronic Health Records; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies
keywords: Alcohol use disorder; Bariatric surgery; Relapse; Roux-en-Y gastric bypass (RYGB)