Epidemiology and Biostatistics department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Psychiatry. 2013 Sep 26;13:236. doi: 10.1186/1471-244X-13-236.
The prevalence of depression is not well studied among women with pelvic floor disorders. Hence, this study aimed to determine the prevalence of depression and its associated factors among women with pelvic floor disorders.
A cross-sectional study was conducted among 306 women with one or more of the advanced pelvic floor disorders who attended at the gynaecologic outpatient clinic of Gondar university referral hospital in the six months data collection period. Women who complained of urinary or faecal incontinence or protruding mass per vagina were assessed and staged accordingly. Eligible women i.e. those with advanced pelvic organ prolapse or obstetric fistula were included consecutively. A structured questionnaire was used to obtain socio-demographic data and medical histories for all consenting women. Interviews were done by a female midwife nurse. Depression measures were obtained using the Beck's Depression Inventory (BDI) tool administered by the midwife nurse after intensive training. Data were entered into a computer using Epi Info version 3. 5.3, and then exported to SPSS version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify associated factors.
Of the 306 women interviewed, 269 had advanced pelvic organ prolapse (stages 3 and 4), 37 had obstetric fistula. All four women (100%) with both faecal and urinary incontinence, 97.0% those with urinary incontinence due to obstetric fistula and 67.7% of those with advanced pelvic organ prolapse (stages 3 and 4) had symptoms of depression. Depression was significantly associated with age 50 years or older (P < 0.01), marital status (P < 0.05), history of divorce (p < 0.01), self perception of severe problem (P < 0.05), and having stage 3 pelvic organ prolapse (P < 0.01).
Women with advanced pelvic organ prolapse, and obstetric fistula had high prevalence of depressive symptoms. A holistic management approach, including mental health care is recommended for women having such severe forms of pelvic floor disorders.
患有盆底功能障碍的女性中，抑郁的患病率尚未得到充分研究。因此，本研究旨在确定患有盆底功能障碍的女性中抑郁的患病率及其相关因素。
在六个月的数据收集期间，对 306 名患有一种或多种高级盆底功能障碍的女性进行了横断面研究。对抱怨尿失禁或粪便失禁或阴道突出肿块的女性进行了评估和分期。符合条件的女性，即患有高级盆腔器官脱垂或产科瘘的女性，连续纳入研究。使用结构化问卷获得所有同意的女性的社会人口统计学数据和病史。由女性助产士护士进行访谈。在经过强化培训后，由助产士护士使用贝克抑郁量表（BDI）工具评估抑郁程度。数据使用 Epi Info 版本 3.5.3 录入计算机，然后导出到 SPSS 版本 20 进行分析。拟合多因素逻辑回归，并计算优势比及其 95%置信区间，以确定相关因素。
在接受访谈的 306 名女性中，269 名患有高级盆腔器官脱垂（3 期和 4 期），37 名患有产科瘘。所有四名（100%）患有粪便和尿液失禁的女性、97.0%因产科瘘导致尿失禁的女性和 67.7%患有高级盆腔器官脱垂（3 期和 4 期）的女性都有抑郁症状。年龄在 50 岁或以上（P < 0.01）、婚姻状况（P < 0.05）、离婚史（p < 0.01）、自我感知严重问题（P < 0.05）和患有 3 期盆腔器官脱垂（P < 0.01）与抑郁显著相关。
患有高级盆腔器官脱垂和产科瘘的女性抑郁症状的患病率较高。建议对患有此类严重盆底功能障碍的女性采用整体管理方法，包括心理健康护理。
