Gath D, Rose N, Bond A, Day A, Garrod A, Hodges S
Oxford University Department of Psychiatry, Warneford Hospital.
Psychol Med. 1995 Mar;25(2):277-83. doi: 10.1017/s0033291700036175.
This paper compares the findings of three studies carried out at intervals over the years 1975-1990. The three studies were concerned with different issues, but each study examined psychiatric morbidity among women undergoing hysterectomy for menorrhagia of benign origin. In all three studies levels of psychiatric morbidity were measured before the operation and 6 months after the operation. Psychiatric morbidity was measured with the Present State Examination (PSE) (Wing et al. 1974), and with established self-report questionnaires. Levels of psychiatric morbidity fell significantly across the three studies. In Study 1, the proportions of psychiatric cases were 58% before hysterectomy and 26% after; in Study 2, 28% before and 7% after; and in Study 3, 9% before and 4% after. The decline in psychiatric morbidity was not associated with demographic and social characteristics, previous psychiatric history, family psychiatric history, the nature of the women's menstrual complaints, or the women's understanding and expectations of the operation. In Study 3 anti-menorrhagic drugs were prescribed twice as frequently as in the two previous studies; while the prescribing of psychotropic medication was significantly higher in Study 1 than in Study 2 or Study 3. The implications of these findings are discussed.
本文比较了在1975年至1990年期间每隔一段时间开展的三项研究的结果。这三项研究关注不同的问题，但每项研究都调查了因良性原因导致月经过多而接受子宫切除术的女性的精神疾病发病率。在所有三项研究中，精神疾病发病率均在手术前和手术后6个月进行测量。精神疾病发病率采用《现况检查》（PSE）（Wing等人，1974年）以及既定的自我报告问卷进行测量。在这三项研究中，精神疾病发病率均显著下降。在研究1中，子宫切除术前精神病例的比例为58%，术后为26%；在研究2中，术前为28%，术后为7%；在研究3中，术前为9%，术后为4%。精神疾病发病率的下降与人口统计学和社会特征、既往精神病史、家族精神病史、女性月经问题的性质，或女性对手术的理解和期望无关。在研究3中，抗月经过多药物的处方频率是前两项研究的两倍；而研究1中精神药物的处方量显著高于研究2或研究3。本文讨论了这些发现的意义。
