Psychological profile of depressed women undergoing hysterectomy

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Abstract
This study examines the biopsychosocial factors associated with depression in gynecological interventions. The sample consists of 152 women undergoing hysterectomy and 72 women undergoing gynecological operations other than hysterectomy but of similar importance. Depression was assessed before the operation by HRS-D and Zung SDS and after the operation by Zung SDS mailed 5 times during a 1-year period. A questionnaire evaluating various fears, anxieties, feelings of mutilation, misconceptions, as well as satisfaction with gynecologist was filled out by all women before the operation and 1 year afterwards. Fifty-one women were found to be depressed at 1 or more of the observations. These depressed women were compared with 49 women who had the lowest scores on depression. Variables related to depression were analyzed first in the whole sample, then in each of the 2 groups. The results show that, in both groups, depression was significantly associated with past history of depression and lower education. The depressed women undergoing hysterectomy, however, experienced more fears, particularly fears related to changes in sexual life and spousal relationship. They were more likely to be married or living with a partner, to have an emergency operation, and to view this intervention as an assault on their body integrity. They were also more likely to be dissatisfied with their gynecologist. These results tend to suggest that the inner representation of hysterectomy plays a great role in the development of depression associated with this intervention. Education and an empathic attitude on the part of the family and the surgeon may contribute to improve the pre- and postoperative adjustment of women undergoing hysterectomy.

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