Prospective Study of Psychiatric Morbidity and Evaluation of Quality of Life in Patients Undergoing Hysterectomy

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Authors

  • Professor & Head, Department of Psychiatry, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra ,IN
  • PG Resident, Department of Psychiatry, Dr. Vasantrao Pawar Medical College Hospital & RC, Nashik – 422003, Maharashtra ,IN

DOI:

https://doi.org/10.18311/mvpjms/2018/v5i2/18271

Keywords:

Hysterectomy, Psychiatry, Quality of Life
Psychiatric

Abstract

Background: Hysterectomy is the most common gynecological operation in the world, secondary to caesarian section. However, women undergoing hysterectomy face a multitude of psychosocial problems both before and after hysterectomy. Aims: To study and compare psychiatric morbidity, quality of life in patients on admission and after about 6 weeks post hysterectomy. Methods and Methodology: A total number of 100 women undergoing hysterectomy were included after they satisfied the eligibility criteria. Written informed consent was taken from all the study participants. After being evaluated by the inpatient Department of Obstetrics and Gynecology, such cases along with records of hospitalization and treatment were evaluated for any psychiatric morbidity and quality of life was assessed. Instruments used for assessment include WHOQOL-BREF, M.I.N.I, and Semi structured proforma. Results: There was overall improvement in psychiatric morbidity (30% to 12%). There was improvement in all domains of quality of life (p<0.0001). Conclusion: Most patients undergo hysterectomy to relieve symptoms and to improve their quality of life. Further research should be done to assess long term impact of hysterectomy.

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Published

2019-04-17

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Section

Original Research Article

 

References

Keshavaraz H, Susan HD, Burney KA, Polly MA. Hysterectomy surveillance- United States, 1994-1999; 2002. Available from: https://www.cdc.gov/Mmwr/preview/mmwrhtml/ss5105a1.htm

Ghant MS, Sengoba KS, Recht H, Cameron KA, Lawson AK, Marsh EE. Beyond the physical: A qualitative assessment of the burden of symptomatic uterine fibroids on women's emotional and psychosocial health. J Psychosom Res. 2015; 78(5):499– 503. https://doi.org/10.1016/j.jpsychores.2014.12.016

Mendonsa RD, Appaya P. Psychiatric morbidity in outpatients of gynecological oncology clinic in a tertiary care hospital. Indian J Psychiatry. 2010; 52(4):327–332. https://doi.org/10.4103/0019-5545.74307

Helmy YA, Hassanin IMA, Elraheem TA, Bedaiwy AA, Peterson RS, Bedaiwy MA. Psychiatric morbidity following hysterectomy in Egypt. Int J Gynecol Obstet. 2008; 102(1):60-64. https://doi.org/10.1016/j.ijgo.2008.02.007

Tsoh JM, Leung HC, Ungvari GS, Lee DT. Brief acute psychosis following hysterectomy in ethnopsychiatric context. Singapore Med J. 2000; 41(7):359–62. PMid:11026805

Darwish M, Atlantis E, Mohamed-Taysir T. Psychological outcomes after hysterectomy for benign conditions: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014; 174(1):5–19. https://doi.org/10.1016 /j.ejogrb. 2013. 12. 017

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998; 59Suppl(20):22-33-57.

WHO | WHO Quality of Life-BREF (WHOQOLBREF). WHO; 2013. Available from: http://www.who.int/ substance_abuse/research_tools/whoqolbref/en/ 9. Bhatia MS, Kaur N, Bohra N, Goyal U. Psychiatric reactions in hysterectomy. Indian J Psychiatry. 1990; 32(1):52–6. PMid:21927427 PMCid:PMC2989570

Schaffer JI, Word A. Hysterectomy ” Still a Useful Operation. N Engl J Med. 2002; 347(17):1360–62. https://doi.org/10.1056/NEJMe020109

Desai S, Campbell OM, Sinha T, Mahal A, Cousens S. Incidence and determinants of hysterectomy in a low-income setting in Gujarat, India-and-determinantsofhysterectomy-in-a by guest. Health Policy Plan. 2017; 32:68–78. https://doi.org/10.1093/heapol/czw099

Bahri N, Tohidinik HR, Fathi Najafi T, Larki M, Amini T, Askari Sartavosi Z. Depression Following Hysterectomy and the Influencing Factors. Iran Red Crescent Med J. 2016; 18(1):e30493. https://doi.org/10.5812/ircmj.30493

Okunlola M, Umuerri C, Omigbodun OO, Morhason-Bello IO, Okonkwo SN, Ojengbede O. Pattern of mental ill health morbidities following hysterectomy for benign gynaecological disorders among Nigerian women. Int J Ment Health Syst. 2009; 3(1):18. https://doi.org/10.1186/1752-4458-3-18

Gath D, Osborn M, Bungay G, et al. Psychiatric disorder and gynaecological symptoms in middle aged women: a community survey. Br Med J (Clin Res Ed). 1987; 294(6566):213–8. https://doi.org/10.1136/ bmj.294.6566.213

Carlson KJ, Miller BA, Fowler FJ. The Maine women's health study: I. Outcomes of hysterectomy. Obstet Gynecol. 1994; 83(4):556–65. https://doi.org/10.1097/00006250199404000-00012 PMid:8134066

Bebbington P, Hurry J, Tennant C, Sturt E, Wing JK. Epidemiology of mental disorders in Camberwell.

Psychol Med. 1981; 11(3):561–79. https://doi.org/10.1017/S0033291700052879 PMid:6973770

Shah S, Wagan MA SS. Incidence of anxiety and depression in women undergoing hysterectomy. Pak J Pharmacol. 2007; 24(23-8).

Chaudhary S, Bhattacharyya TK. Psychiatric effects of hysterectomy. Med journal, Armed Forces India. 1995; 51(1):27–30. https://doi.org/10.1016/S0377-1237(17)30914-0

Gath D, Rose N, Bond A, Day A, Garrod A, Hodges S. Hysterectomy and psychiatric disorder: are the levels of psychiatric morbidity falling? Psychol Med. 1995; 25(2):277– 283. https://doi.org/10.1017/S0033291700036175

Chou P-H, Lin C-H, Cheng C, et al. Risk of depressive disorders in women undergoing hysterectomy: A population-based follow-up study. J Psychiatr Res. 2015; 68:186–91. https://doi.org/10.1016/j.jpsychires.2015.06.017

Vandyk AD, Brenner I, Tranmer J, et al. Depressive symptoms before and after elective hysterectomy. J Obstet Gynecol Neonatal Nurs. 2011; 40(5):566–76. https://doi.org/10.1111/j.1552-6909.2011.01278.x

Ryan MM, Dennerstein L, Pepperell R. Psychological aspects of hysterectomy. A prospective study. Br J Psychiatry. 1989; 154(4):516–22. https://doi.org/10.1192/bjp.154.4.516

Yasmin FN. Depression and anxiety in patients undergoing hysterectomy.

Rannestad T, Eikeland OJ, Helland H, Qvarnström U. The quality of life in women suffering from gynecological disorders is improved by means of hysterectomy. Absolute and relative differences between pre- and post-operative measures. Acta Obstet Gynecol Scand. 2001; 80(1):46–51. https://doi.org/10.1097/00006254-200106000-00012

Thakar R, Ayers S, Georgakapolou A, Clarkson P, Stanton S, Manyonda I. Hysterectomy improves quality of life and decreases psychiatric symptoms: a prospective and randomised comparison of total versus subtotal hysterectomy. BJOG An Int J Obstet Gynaecol. 2004; 111(10):1115–20.

https://doi.org/10.1111/j.1471-0528.2004.00242.x

Lee C-F, Wen F-H, Lin S-S, Lin H-M. Changing quality of life in hysterectomized women. J Formos Med Assoc. 2009; 108(5):414–22. https://doi.org/10.1016/S0929-6646 (09) 60086-3

Chandana J, Asanka G, Champika G, Sajith B, Kushangi D. Post-operative quality of life assessment after total abdominal hysterectomy. J Gynecol Reprod Med Gynecol Reprod Med J Gynecol Reprod Med. 2017; 1(5):1–4. https://doi.org/10.33425/2639-9342.1016