title: Two-year trends in psychological outcomes after gastric bypass in adolescents with severe obesity.
abstract: OBJECTIVE
  This study aimed to evaluate changes in mental health over 2 years in adolescents undergoing gastric bypass.
  
  
  METHODS
  Eighty-eight adolescents (65% girls) aged 13 to 18 years were assessed at baseline and 1 and 2 years after surgery. Generic and obesity-specific questionnaires were used to evaluate outcomes in mental health, also in relation to age- and gender-specific norms.
  
  
  RESULTS
  Symptoms of anxiety (P = 0.001), depression (P = 0.001), anger (P = 0.001), and disruptive behavior (P = 0.022) were significantly reduced at 2 years after surgery, as were obesity-related problems (P < 0.001). Self-esteem (P < 0.001), self-concept (P < 0.001), and overall mood (P = 0.025) improved significantly. Improvements were mainly observed during the first year after surgery. The second year was characterized by stabilization. Symptoms of anxiety, depression, anger, disruptive behavior, and self-concept were at normative levels after surgery. However, 19% of the adolescents had depressive symptoms in the clinical range.
  
  
  CONCLUSIONS
  A substantial improvement in mental health in adolescents over the first 2 years after gastric bypass was found. Most adolescents had a level of mental health and self-concept similar to norms, but a marked subgroup showed substantial depressive symptoms 2 years after surgery.
authors.affiliation: Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden.|Department of Psychology, Lund University, Lund, Sweden.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Järvholm
authors.affiliation: Centre for Health Care Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Karlsson
authors.affiliation: Department of Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Torsten
authors.initials: T
authors.lastname: Olbers
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Peltonen
authors.affiliation: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Claude
authors.initials: C
authors.lastname: Marcus
authors.affiliation: Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Jovanna
authors.initials: J
authors.lastname: Dahlgren
authors.affiliation: Department of Pediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Gronowitz
authors.affiliation: Department of Psychology, Lund University, Lund, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Johnsson
authors.affiliation: Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden.
authors.forename: Carl-Erik
authors.initials: CE
authors.lastname: Flodmark
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D012649:Self Concept; D011795:Surveys and Questionnaires; D016896:Treatment Outcome