Persistent depression after obstetric fistula repair

Objective To measure depression over time using the Patient Health Questionnaire 9 (PHQ‐9) and identify characteristics associated with persistent depression. Methods A database of women undergoing obstetric fistula repair was used to examine associations between depression and variables such as dem...

Full description

Saved in:
Bibliographic Details
Published in:International journal of gynecology and obstetrics 2019-11, Vol.147 (2), p.206-211
Main Authors: Stokes, Mary J., Wilkinson, Jeffrey P., Ganesh, Prakash, Nundwe, William, Pope, Rachel J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Case-Control Studies
Depression
Depressive Disorder - epidemiology
Depressive Disorder - etiology
Depressive Disorder - psychology
Female
Global women's health
Humans
Incontinence
Maternal health
Mental health
Middle Aged
Obstetric fistula
Postoperative Complications - epidemiology
Postoperative Complications - psychology
Postoperative Period
Pregnancy
Quality of Life
Retrospective Studies
Urinary Incontinence - epidemiology
Urinary Incontinence - psychology
Vesicovaginal Fistula - classification
Vesicovaginal Fistula - epidemiology
Vesicovaginal Fistula - psychology
Vesicovaginal Fistula - surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To measure depression over time using the Patient Health Questionnaire 9 (PHQ‐9) and identify characteristics associated with persistent depression. Methods A database of women undergoing obstetric fistula repair was used to examine associations between depression and variables such as demographics, type of fistula, and postoperative continence status. Results A total of 797 patients completed the PHQ‐9 at the initial preoperative assessment; 365 (45.8%) had a PHQ‐9 score of 5 or higher, indicating depression. Preoperatively, depression was associated with women aged 18–34 years, with no children, and with fistula for 5 years or less. Postoperatively, depression was associated with persistent incontinence. Over time, however, depression was rarely found among women returning for follow‐up. Conclusion Postoperative depression decreased over time in women who returned for follow‐up, either due to selection bias or due to improved adjustment to one's circumstances. This study underscores the need for ongoing follow‐up, especially for those not presenting for care or with persistent incontinence. Women with incontinence after obstetric fistula repair remain at risk of depression; long‐term follow‐up and support, however, may improve depression without formal mental health intervention.
ISSN:0020-7292
1879-3479
DOI:10.1002/ijgo.12945