Prevalance and correlates of self harm behaivors and suicide among bariatric surgery candidates

Objective: In this study, it was aimed to evaluate the patients' self-harm profiles, the frequency of suicidal thoughts-behaviors and to determine the clinical and sociodemographic factors associated with these behaviors by psychiatric evaluation of patients who are preparing for bariatric surgery. Materials and Methods: This study was carried out between September 2020 and May 2021 on all consecutive outpatients that were consulted to the Department of Psychiatry for the purpose of pre-bariatric evaluation by the Obesity Center at Düzce University Faculty of Medicine. All patients (n=70) over the age of 18 who could understand and answer the scales appropriately and volunteered to participate were included in the study. After clinical interview with each participant according to DSM-V diagnostic criteria, Socio-demographic data form, Inventory of Statements About Self-injury (ISAS), Columbia Suicide Severity Rating Scale (C-SSRS), The Eating Attitudes Test 40 (EAT-40), Eating Disorder Examination Questionnaire (EDE-Q), Dutch Eating Behavior Questionnaire (DEBQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Night Eating Questionnaire (NEQ) were applied. Results: The rate of suicide attempts of the surgical candidates was 2.85% and the lifetime suicidal ideation rate according to C-SSRS was 31.4%. Acoording to ISAS scores 11 participants (%15,7) had a history of at least one self injury behaviour. According to C-SSRS, in those with lifetime suicidal ideation; unemployment, medical illness, BDI score, EDE-Q total score, DEBQ emotional eating subscale and NEQ morning appetite subscale mean rank values were found to be significantly higher (respectively p=0.016, p=0.042, p=0.033, p=0.033, p=0.026, p=0.032). In the logistic regression analysis; according to the C-SSRS, lifetime suicidal ideation odds ratio increases 6.17 times in the unemployed, 3.41 times in those with a medical illness, and 1.73 times with the increase in the DEBQ emotional eating subscale score. Conclusion: Suicide attempts and life time suicidal thoughts are prevalent among bariatric surgery candidates. According to the results of the research, while suicidal thoughts and behaviors are questioned in patients evaluated before bariatric surgery, a detailed evaluation including unemployment, presence of medical illness and emotional eating should be done. Key Words: Suicide, self-injury, bariatric surgery, obesity, psychopathology