Association between hysterectomy and depression: a longitudinal follow-up study using a national sample cohort.

Objectives: This study investigated the influence of hysterectomy on depression using a national sample cohort from South Korea.

Methods: We extracted data entered into the Korean Health Insurance data based form 2002 through 2013 and classified patients into a group of women who had undergone a hysterectomy (n = 9,971) and a 1:4 matched control group (n = 39,884). A Cox proportional hazards model was used to analyze the hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the risk of depression in the hysterectomy group and the control group. The HR was calculated as the risk of depression in the hysterectomy group compared to that in the control group.

Results: The incidence of depression in the hysterectomy group was 6.59 per 1,000 person-years and that in the control group was 5.70 per 1,000 person-years. The adjusted HR for depression was 1.15 in the hysterectomy group (95% CI = 1.03-1.29, P < 0.05). In a subgroup analysis, the adjusted HR for depression was 1.16 (95% CI; 1.03-1.31, P = 0.014) for patients who underwent hysterectomy without bilateral salpingo-oophorectomy. In an additional subgroup analysis, the adjusted HR for depression after hysterectomy was 1.18 (95% CI; 1.04-1.35, P = 0.012) in the younger than 50-year-old group.

Conclusion: The incidence of depression was higher in women who underwent hysterectomy than in the matched control group.