Psychiatric morbidity and the menopause: survey of a gynaecological out-patient clinic.

Two hundred and seventeen women between the ages of 40 and 55 years referred to a gynaecological out-patient clinic were screened for psychiatric illness by means of the General Health Questionnaire (GHQ) and a brief special questionnaire. Of the 114 women identified as possible psychiatric 'cases' 104 were interviewed. A standardized psychiatric interview schedule was used. Compared with a general population sample from the same geographical area and in the same age range, women presenting at the gynaecological out-patient clinic were predominantly pre-menopausal and from the lower end of the 15-year age range, and were more likely to be separated or divorced, less likely to be single, and more likely to have had previous or to have subsequent contact with the local psychiatric services. A higher proportion of women were identified as psychiatric 'cases' in the clinic population than in the general population, and their psychiatric disorder appeared to be severe and more depressive in nature. The findings for this age group support the view that among women presenting for hysterectomy there is already an excess of psychiatric illness before the operation. The association of gynaecological complaints and psychiatric morbidity in the pre-menopausal years is discussed.