title: Characteristics of adolescents with poor mental health after bariatric surgery.
abstract: BACKGROUND
  About 20% of adolescents experience substantial mental health problems after bariatric surgery.
  
  
  OBJECTIVE
  The aim of this study was to explore differences between adolescents with poor mental health (PMH) 2 years after surgery and those with average/good mental health.
  
  
  METHODS
  Three university hospitals in Sweden.
  
  
  METHODS
  Mental health and health-related quality of life were assessed in 82 of 88 adolescents (mean age: 16.8 yr, 67% female) at baseline and 1 and 2 years after laparoscopic gastric bypass. Possible associations among mental health, weight, and biochemical outcomes were explored.
  
  
  RESULTS
  Two years after surgery 16 (20%) adolescents were identified as having PMH. More symptoms of anxiety and depression and worse mental health at baseline significantly predicted PMH 2 years later. The decline in mental health for the PMH group happened mainly during the second year after surgery. Suicidal ideation was reported in 14% of the total sample 2 years postsurgery and was more frequent in the PMH group. Weight outcomes between groups were comparable at all time points, and physical health was equally improved 2 years after surgery.
  
  
  CONCLUSIONS
  Although adolescents with PMH after surgery lose as much weight and have similar improvements in physical health compared with other adolescents, special attention should be given to adolescents who report mental health problems at baseline and follow-up, especially during the second year after gastric bypass. The high prevalence of suicidal ideation in adolescents 2 years after bariatric surgery is another indication that longer follow-up is necessary.
authors.affiliation: Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden; Department of Psychology, Lund University, Lund, Sweden. Electronic address: kajsa.jarvholm@psy.lu.se.
authors.forename: Kajsa
authors.initials: K
authors.lastname: Järvholm
authors.affiliation: University Health Care Research Center, 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 Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 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: D000293:Adolescent; D001008:Anxiety Disorders / Q000209:etiology; D015415:Biomarkers / Q000378:metabolism; D003866:Depressive Disorder / Q000209:etiology; D004644:Emotions; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000523:psychology*; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D063766:Pediatric Obesity / Q000523:psychology* / Q000601:surgery; D011183:Postoperative Complications / Q000523:psychology; D011379:Prognosis; D011788:Quality of Life; D012649:Self Concept; D059020:Suicidal Ideation; D013548:Sweden
chemical_list: D015415:Biomarkers
keywords: Adolescents; Anxiety; Bariatric surgery; Depression; Health-related quality of life; Mental health