Bariatric surgery and mental health outcomes: an Umbrella Review

By Buddy T

Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance Alcohol Brain Fog: How to Heal Your Brain of anonymity at the public level, he does not use his photograph or his real name on this website. In general, AUDs tend to be more prevalent in individuals with lower levels of education and lower income.

Most AUD treatment is provided in outpatient settings.17,18 About half of AUD patients will have some symptoms of withdrawal when they stop drinking,2,19 and a small proportion need intensive inpatient or outpatient “detox” to manage potentially dangerous withdrawal symptoms.2,20 Detox alone does not constitute treatment, however. Continued care in residential or outpatient settings or both is often needed to sustain abstinence and promote long-term recovery. Across settings, a course of AUD treatment is likely to be measured in months, not days or weeks.


For example, the criterion of legal problems related to alcohol was removed, and the criterion of alcohol craving was added. Thus, where possible, this review identifies which version of the DSM was used in a study. The emerging secondary use of electronic medical records (EMRs) for research purposes is occurring throughout the world [59]. As EMRs become more widely adopted in primary health care, research in these settings will be improved. Information from primary care EMRs can be used to evaluate the treatment outcome and uptake and also treatment fidelity, which would be particularly useful for evaluating psychosocial interventions (to the extent that these are recorded). EMRs can also be used to evaluate implementation facilitators and barriers and potentially assist in recruitment by earlier screening for alcohol problems [60].

Based on postmortem blood alcohol concentrations, AUA was commonly present among those who died by suicide. AUA is a potent proximal risk factor for suicidal behavior, and the risk increases with the amount of alcohol consumed, consistent with a dose-response relationship. Research indicates that AUA increases risk for suicidal behavior by lowering inhibition and promoting suicidal thoughts. There is support for policies that serve to reduce alcohol availability in populations with high rates of AUD and suicide, that promote AUD treatment, and that defer suicide risk assessments in intoxicated patients to allow the blood alcohol concentration to decrease. Brief tools are available to help non-specialists assess for AUD and screen for common co-occurring mental health conditions.

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