Depressive symptoms before and after elective hysterectomy

Amanda Digel Vandyk, Amanda Vandyk, Ingrid Brenner, Joan Tranmer, Elizabeth Van Den Kerkhof
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2011 · vol. 40(5) , pp. 566–576 · doi:10.1111/j.1552-6909.2011.01278.x · PMID:22273413 · W2140874512
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This study examined changes in depressive symptoms in women undergoing elective hysterectomy, comparing pre-operative and post-operative assessments.

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Abstract

OBJECTIVE: To examine the factors associated with depressive symptoms before and after surgery in women who undergo elective hysterectomy. DESIGN: A secondary analysis of longitudinal data from a prospective cohort study designed to understand chronic postsurgical pain in women. SETTING: One acute care hospital in southeastern, Ontario, over a 4-year period (2006-2010). PARTICIPANTS: Three hundred eighty-four (384) English-speaking women, age 18 years or older, who presented for elective hysterectomies. METHODS: Data were gathered preoperatively in the same-day admission center and six months postoperatively using validated web-based or mailed questionnaires. RESULTS: Thirty six percent (36%) of participants reported depressive symptoms before surgery, 22% reported symptoms afterwards, 15% reported symptoms at both time points, and 6% developed new onset depressive symptoms postoperatively. Younger (odds ratio [OR] = 2.5, 95% confidence interval [CI], [1.7, 5.0]) women, those with higher levels of anxiety (state: OR = 8.6, 95% CI [5.2, 14.0]), or who experienced pain that interfered with their daily functioning (OR = 2.8, 95% CI [1.7, 4.7]) were more likely to report depressive symptoms prior to hysterectomy. Preoperative pain (OR = 2.0, 95% CI [1.1, 3.6]), trait anxiety (OR = 2.4, 95% CI [1.2, 4.6]), and depressive symptoms (OR = 3.9, 95% CI [2.1, 7.5]) increased the risk of depressive symptoms 6 months postoperatively. CONCLUSION: Young women who exhibit high levels of anxiety and pain and who require a hysterectomy are at risk of experiencing psychological distress prior to and following their surgery.

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MeSH descriptors

Depression Depression Hysterectomy Adult Aged Age Distribution Cohort Studies Confidence Intervals Depression Depression Elective Surgical Procedures Female Follow-Up Studies Humans Hysterectomy Hysterectomy Incidence Middle Aged Odds Ratio Ontario

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