Depressive Symptoms Before and After Elective Hysterectomy

Abstract

To examine the factors associated with depressive symptoms before and after surgery in women who undergo elective hysterectomy. A secondary analysis of longitudinal data from a prospective cohort study designed to understand chronic postsurgical pain in women. One acute care hospital in southeastern, Ontario, over a 4-year period (2006-2010). Three hundred eighty-four (384) English-speaking women, age 18 years or older, who presented for elective hysterectomies. Data were gathered preoperatively in the same-day admission center and six months postoperatively using validated web-based or mailed questionnaires. 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. 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.