Risk of Admission to Mental Hospital Following Hysterectomy or Cholecystectomy

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Abstract
This study was designed to test the hypothesis that because of the symbolic significance of the uterus, hysterectomy might be followed by a higher incidence of mental illness requiring hospitalization than would surgery involving comparable physical trauma but without similar symbolic significance (cholecystectomy). The study groups consisted of patients having had either a hysterectomy (1,601) or a cholecystectomy (1,162) at 1 of 2 Boston Hospitals during the period Jan. 1, 1948 to Dec. 31, 1959. For each of these study patients an abstract was prepared including identifying data, so that those who were admitted to mental hospitals could be identified. Three indexes of differential risk were used: total mental hospitalization rates; mental hospitalization rates for psychoses; standard readmission rates. There were 2 comparisons employed: The cholecystectomy and hysterectomy groups were compared directly; the observed number of mental hospital admissions in each group was compared with the number that would have been expected in the group had the general population rates for Massachusetts females, 1950, been applicable. The study indicated that: the risk of admission to a mental hospital following hysterectomy was higher than that following cholecystectomy (but not significantly so), with the risk being higher for the age group 30-39; there was no significant difference in the observed and expected number of admissions for psychosis for the hysterectomy and cholecystectomy groups; diagnostic categories other than the psychoses account for the excess admissions observed in the hysterectomized group; the mental-hospitalized hysterectomy patient remained in the mental hospital on an average of almost 5 times as long as the cholecystectomy mental-hospitalized patient; 21% of the post operative mental-hospitalized hysterectomy patients had a family history of mental hospitalization as compared with none for the cholecystectomy group.

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