Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
Menopause. 2019 Dec;26(12):1395-1404. doi: 10.1097/GME.0000000000001413.
We studied eight mental health conditions diagnosed before bilateral oophorectomy performed for nonmalignant indications.
We identified 1,653 premenopausal women who underwent bilateral oophorectomy for a nonmalignant indication in Olmsted County, Minnesota, during a 20-year period (1988-2007). Each woman was matched by age (±1 year) to one population-based control who had not undergone bilateral oophorectomy before the index date (age range: 21-49 years). Both cases and controls were identified using the records-linkage system of the Rochester Epidemiology Project (REP http://www.rochesterproject.org). For eight mental health conditions, we calculated odds ratios (ORs) and their 95% confidence intervals (95% CIs) adjusted for race, education, and income using conditional logistic regression.
Pre-existing mood disorders, anxiety disorders, and somatoform disorders were associated with increased risk of bilateral oophorectomy in overall analyses. These associations were also significant in women ≤45 years of age at index date. Personality disorders were associated with increased risk only in overall analyses and adjustment disorders only in women 46 to 49 years of age. Some of the associations were significantly different across strata by age at index date and by indication. There was also a linear trend of increasing adjusted ORs from 1.55 (95% CI 1.31-1.83) for one mental health condition to 2.19 (95% CI 1.40-3.41) for three or more conditions (trend P < 0.001).
We identified several mental health conditions that were associated with bilateral oophorectomy for nonmalignant indications. Awareness of these associations may guide women and physicians in future decision-making and limit unindicated bilateral oophorectomies. VIDEO SUMMARY:: http://links.lww.com/MENO/A458.
我们研究了 8 种在因非恶性指征行双侧卵巢切除术之前诊断出的心理健康状况。
我们在明尼苏达州奥姆斯特德县（Olmsted County）确定了 1653 名在 20 年期间（1988-2007 年）因非恶性指征行双侧卵巢切除术的绝经前妇女。每位女性都通过年龄（±1 岁）与一名未在指数日期（年龄范围：21-49 岁）前接受双侧卵巢切除术的基于人群的对照相匹配。通过罗切斯特流行病学项目（Rochester Epidemiology Project，REP http://www.rochesterproject.org）的记录链接系统识别病例和对照。对于 8 种心理健康状况，我们使用条件逻辑回归计算了调整种族、教育和收入后的比值比（OR）及其 95%置信区间（95%CI）。
在总体分析中，预先存在的情绪障碍、焦虑障碍和躯体形式障碍与双侧卵巢切除术的风险增加相关。这些关联在指数日期≤45 岁的女性中也具有统计学意义。人格障碍仅在总体分析和调整障碍中与风险增加相关，仅在 46-49 岁的女性中与风险增加相关。一些关联在按年龄和指征分层时存在显著差异。调整后的 OR 也呈现出从一种心理健康状况的 1.55（95%CI 1.31-1.83）到三种或更多状况的 2.19（95%CI 1.40-3.41）的线性趋势（趋势 P<0.001）。
我们确定了几种与非恶性指征行双侧卵巢切除术相关的心理健康状况。这些关联的认识可能会指导女性和医生在未来的决策中，并限制不必要的双侧卵巢切除术。视频摘要：http://links.lww.com/MENO/A458。
