title: Depressive symptoms before and after elective hysterectomy.
abstract: OBJECTIVE
  To examine the factors associated with depressive symptoms before and after surgery in women who undergo elective hysterectomy.
  
  
  METHODS
  A secondary analysis of longitudinal data from a prospective cohort study designed to understand chronic postsurgical pain in women.
  
  
  METHODS
  One acute care hospital in southeastern, Ontario, over a 4-year period (2006-2010).
  
  
  METHODS
  Three hundred eighty-four (384) English-speaking women, age 18 years or older, who presented for elective hysterectomies.
  
  
  METHODS
  Data were gathered preoperatively in the same-day admission center and six months postoperatively using validated web-based or mailed questionnaires.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesiology & Perioperative Medicine, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, Canada. ev5@queensu.ca
authors.forename: Amanda Digel
authors.initials: AD
authors.lastname: Vandyk
authors.forename: Ingrid
authors.initials: I
authors.lastname: Brenner
authors.forename: Joan
authors.initials: J
authors.lastname: Tranmer
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Van Den Kerkhof
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000523:psychology*; D015994:Incidence; D008875:Middle Aged; D016017:Odds Ratio; D009864:Ontario; D011184:Postoperative Period; D057234:Preoperative Period; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013315:Stress, Psychological; D011795:Surveys and Questionnaires