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Article

Hysterectomies Are Associated with an Increased Risk of Depression: A Population-Based Cohort Study

1
Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
2
Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
3
College of Medicine, China Medical University, Taichung 404, Taiwan
4
Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan
5
Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien 970, Taiwan
6
Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(10), 366; https://doi.org/10.3390/jcm7100366
Received: 24 August 2018 / Revised: 16 October 2018 / Accepted: 17 October 2018 / Published: 18 October 2018
(This article belongs to the Section Psychiatry)
Using the National Health Insurance Research Database of Taiwan, we investigated whether undergoing a hysterectomy increases the risk of depression. A total of 7872 patients aged 30–49 years who underwent a hysterectomy from 2000 to 2013 were enrolled as the hysterectomy group. The comparison group was randomly selected from women who had never undergone a hysterectomy and was four times the size of the hysterectomy group. We calculated adjusted hazard ratios and 95% confidence intervals (CIs) for depression [The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 296.2, 296.3, 300.4, 311] in these cohorts after adjusting for age, comorbidities, oophorectomy, and hormone therapy. The overall incidence of depression was 1.02 and 0.66 per 100 person-years in the hysterectomy and comparison cohorts, respectively, yielding an adjusted hazard ratio of 1.35 (95% CI = 1.22–1.50) for depression risk. When we stratified patients by age, comorbidities, oophorectomy, and hormone use, hysterectomy increased the risk of depression. Hysterectomy, oophorectomy, and post-surgery hormone use were associated with an increased risk of depression when they occurred alone, but conferred a greater risk if they were considered jointly. Hysterectomy would be a predisposing factor for increased risk of subsequent depression. Our findings provide vital information for patients, clinicians, and the government for improving the treatment strategy in the future. View Full-Text
Keywords: hysterectomy; depression; hormone therapy; oophorectomy; cohort hysterectomy; depression; hormone therapy; oophorectomy; cohort
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MDPI and ACS Style

Harnod, T.; Chen, W.; Wang, J.-H.; Lin, S.-Z.; Ding, D.-C. Hysterectomies Are Associated with an Increased Risk of Depression: A Population-Based Cohort Study. J. Clin. Med. 2018, 7, 366. https://doi.org/10.3390/jcm7100366

AMA Style

Harnod T, Chen W, Wang J-H, Lin S-Z, Ding D-C. Hysterectomies Are Associated with an Increased Risk of Depression: A Population-Based Cohort Study. Journal of Clinical Medicine. 2018; 7(10):366. https://doi.org/10.3390/jcm7100366

Chicago/Turabian Style

Harnod, Tomor, Weishan Chen, Jen-Hung Wang, Shinn-Zong Lin, and Dah-Ching Ding. 2018. "Hysterectomies Are Associated with an Increased Risk of Depression: A Population-Based Cohort Study" Journal of Clinical Medicine 7, no. 10: 366. https://doi.org/10.3390/jcm7100366

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