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Psychiatric outcomes after hysterectomy in women with uterine myoma: a population-based retrospective cohort study

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Abstract

Controversy regarding psychological or psychiatric outcomes following hysterectomy still exists. The purpose of this study was to investigate the risk of postoperative psychiatric disorders in women with hysterectomy compared to that in women with uterus-conserving surgery for myomas by using population-based data from South Korea. This study was designed as a retrospective cohort study. We analyzed the National Health Insurance Service National Sample Cohort data including all administrative medical claims from 2002 to 2013. The study population, consisting of 9581 women, was defined as those diagnosed with uterine myoma who underwent medical procedures. The association between psychiatric and mood disorders and hysterectomy was assessed using Cox proportional hazard regression. During the study period, 1381 (14.4%) women experienced psychiatric disorders and 374 (3.9%) experienced mood disorders. The hazard ratio (HR) for psychiatric disorder was higher in women after hysterectomy than in women after uterus-conserving procedures (adjusted HR = 1.44; 95% CI = 1.27–1.64, p < 0.0001). In addition, the HR for mood disorders in women after hysterectomy was significantly higher than in women after uterus-conserving procedures (adjusted HR = 1.62; 95% CI = 1.26–2.08, p = 0.0002). Our study suggests that hysterectomy increased the risk of psychiatric disorders compared to uterus-conserving procedures in women with uterine myoma. Considering these findings, more focus on psychological responses in women following hysterectomy is needed, and appropriate psychosocial support or provisioning of information before or after procedures could reduce psychological distress.

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Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea

    Hyo Jung Lee & Seung Ju Kim

  2. Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyo Jung Lee, Seung Ju Kim & Eun-Cheol Park

  3. Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea

    Eun-Cheol Park

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  1. Hyo Jung Lee
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  2. Seung Ju Kim
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Correspondence to Eun-Cheol Park.

Ethics declarations

This study was approved by the Institutional Review Board, Yonsei University Graduate School of Public Health (2014-239). This study did not need informed consent from the patients because the patients’ information was anonymized and de-identified prior to analysis.

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The authors declare that they have no competing interest.

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Lee, H.J., Kim, S.J. & Park, EC. Psychiatric outcomes after hysterectomy in women with uterine myoma: a population-based retrospective cohort study. Arch Womens Ment Health 20, 487–494 (2017). https://doi.org/10.1007/s00737-017-0745-6

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  • DOI: https://doi.org/10.1007/s00737-017-0745-6

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