Xu Chenghui, Zhao Guangchun, Yao Wenlei, Zhang Yanhua
Department of Rehabilitation Medicine, Binhai County People's Hospital, Yancheng, China.
Department of Laboratory Medicine, Binhai County People's Hospital, Yancheng, China.
Sci Rep. 2024 Dec 30;14(1):31995. doi: 10.1038/s41598-024-83675-y.
This study aims to evaluate the association between hysterectomy with bilateral salpingo-oophorectomy (HBSO) and depressive symptoms, exploring the impact of different surgical approaches on the severity of depression. Data from the 2006-2017 National Health and Nutrition Examination Survey (NHANES) were used to analyze the relationship between surgical methods and depressive symptoms.This study analyzed data from 10,780 women aged 20-80 years, with a diverse racial composition: 44.2% non-Hispanic White, 20.4% non-Hispanic Black, 14.7% Mexican American, 11.0% Other Hispanic, and 9.7% Other Race.The Patient Health Questionnaire-9 (PHQ-9), a validated depression screening tool, was utilized to assess depressive symptoms. Multivariable linear regression and binary logistic regression analyses were conducted to evaluate the association between surgical approaches and depressive symptoms, with results presented as odds ratios (OR) and their 95% confidence intervals (CI). Subgroup analyses employed stratified regression models to investigate interactions between baseline characteristics and surgical methods. Demographic analysis showed differences in age, marital status, education, income, smoking, BMI, and chronic disease prevalence between the depressive and non-depressive groups. HBSO was significantly associated with higher PHQ-9 scores and a higher likelihood of significant depressive symptoms (PHQ-9 ≥ 10). Hysterectomy was also associated with depressive symptoms, but to a lesser extent. Further analysis revealed that hysterectomy was significantly associated with higher depressive scores, particularly in the PHQ-9 ≥ 20 group. Subgroup analysis indicated significant interaction effects between surgical types and factors such as BMI, Income-to-Poverty Ratio (IPR), smoking, and alcohol consumption. The findings suggest a significant association between hysterectomy, particularly HBSO, and the severity of depressive symptoms. Lifestyle and behavioral factors, such as BMI, smoking, and alcohol consumption, significantly influence the occurrence of postoperative depression. Thorough evaluation of patients' psychological health and related factors is essential when considering gynecological surgery.
本研究旨在评估子宫切除加双侧输卵管卵巢切除术（HBSO）与抑郁症状之间的关联，探讨不同手术方式对抑郁严重程度的影响。利用2006 - 2017年国家健康与营养检查调查（NHANES）的数据来分析手术方法与抑郁症状之间的关系。本研究分析了10780名年龄在20 - 80岁之间的女性数据，种族构成多样：44.2%为非西班牙裔白人，20.4%为非西班牙裔黑人，14.7%为墨西哥裔美国人，11.0%为其他西班牙裔，9.7%为其他种族。采用经过验证的抑郁筛查工具患者健康问卷 - 9（PHQ - 9）来评估抑郁症状。进行多变量线性回归和二元逻辑回归分析以评估手术方式与抑郁症状之间的关联，结果以比值比（OR）及其95%置信区间（CI）表示。亚组分析采用分层回归模型来研究基线特征与手术方法之间的相互作用。人口统计学分析显示，抑郁组和非抑郁组在年龄、婚姻状况、教育程度、收入、吸烟、体重指数（BMI）和慢性病患病率方面存在差异。HBSO与较高的PHQ - 9评分以及出现显著抑郁症状（PHQ - 9≥10）的可能性较高显著相关。子宫切除术也与抑郁症状有关，但程度较轻。进一步分析表明，子宫切除术与较高的抑郁评分显著相关，特别是在PHQ - 9≥20组。亚组分析表明手术类型与BMI、收入贫困比（IPR）、吸烟和饮酒等因素之间存在显著的交互作用。研究结果表明，子宫切除术，尤其是HBSO，与抑郁症状的严重程度之间存在显著关联。生活方式和行为因素，如BMI、吸烟和饮酒，对术后抑郁的发生有显著影响。在考虑妇科手术时，对患者心理健康及相关因素进行全面评估至关重要。
