Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hanover, Germany.
Department of General, Visceral, and Bariatric Surgery, DRK Krankenhaus Clementinenhaus, Lützerodestr. 1, 30161, Hanover, Germany.
Obes Surg. 2024 Oct;34(10):3579-3591. doi: 10.1007/s11695-024-07439-3. Epub 2024 Aug 13.
Previous research on obesity surgery (OS) showed that patients do not only experience weight loss but also improvements in certain mental health outcomes (e.g., depression) after OS. However, self-harm behaviors might increase after OS. Regarding self-harm, the literature is mostly limited to studies using data from hospital or emergency room charts. This longitudinal study examined self-reported self-harm behaviors and potential psychopathological correlates before and after OS.
Pre-surgery patients (N = 220) filled out a set of questionnaires before and approximately six months after OS. Self-harm behaviors were captured with the Self-Harm Inventory. The assessments further included standardized instruments to measure symptoms of depression, anxiety, eating disorders, alcohol use, and suicidal ideations.
Any self-harm was reported by 24.6% before and by 25.0% after OS. No differences in the number of self-harm behaviors or prevalence of any self-harm before and after OS were found. Overall, 11.4% experienced self-harm behaviors at both times. A subset showed self-harm behaviors only before (13.2%) OS and another subset only after OS (13.6%). These two groups were about the same size. Self-harm behaviors showed strong associations with psychopathology after OS, especially with depression and suicidal ideation.
No increase in self-harm behaviors after OS emerged. Still, a subgroup showed self-harm behaviors after OS closely linked to further psychopathology. This mirrors the need to implement screening for self-harm before and after OS into OS care. Further studies with longer follow up periods are needed to extend these findings.
先前关于肥胖症手术（OS）的研究表明，患者在接受 OS 后不仅会减轻体重，而且某些心理健康结果（例如抑郁）也会得到改善。但是，自伤行为可能会在 OS 后增加。关于自伤，文献大多仅限于使用医院或急诊室图表数据的研究。这项纵向研究检查了 OS 前后自我报告的自伤行为和潜在的心理病理相关性。
术前患者（N=220）在 OS 前和大约 6 个月后填写了一组问卷。自伤行为使用自伤量表进行评估。评估还包括用于测量抑郁、焦虑、饮食障碍、酒精使用和自杀意念症状的标准化工具。
在 OS 前后，分别有 24.6%和 25.0%的患者报告有任何自伤行为。在 OS 前后，自伤行为的数量或任何自伤的发生率均无差异。总体而言，11.4%的患者在两次都有自伤行为。有一部分患者仅在 OS 前（13.2%）有自伤行为，另一部分患者仅在 OS 后（13.6%）有自伤行为。这两个组的人数大致相同。自伤行为与 OS 后心理病理学密切相关，尤其是与抑郁和自杀意念。
OS 后自伤行为没有增加。尽管如此，仍有一部分患者在 OS 后出现自伤行为，且与进一步的心理病理学密切相关。这反映了在 OS 前后的护理中需要将自伤筛查纳入 OS 护理。需要进行具有更长随访期的进一步研究来扩展这些发现。
