Influence of hysterectomy due to leiomyoma on woman’s psychological status

Abstract

The objective: to study the clinical-psychopathological features and psycho-emotional symptoms and borderline mental disorders in women of reproductive age after hysterectomy due to leiomyoma.Materials and methods. An assessment of the psychological state of 160 women after hysterectomy for leiomyoma was carried out. 90 patients of them (average age – 45.9±1.3 years old) had transvaginal hysterectomy, both classic and laparoscopically assisted one with opportunistic salpingectomy (I group) and 70 patients (average age – 47.2±1.6 years old) – abdominal hysterectomy with opportunistic salpingectomy (II group). The control group included 50 women 45.7±1.3 years old with asymptomatic leiomyoma. Clinical psychopathological, anamnestic and experimental psychological methods were used. Pathopsychological methods included methods of visual presentation of the personality profile using the Minnesota Multifaceted Personality Questionnaire. The survey was conducted at the pre-operative period, during the adaptation period and during 12 months. Statistical processing of monitoring data was carried out according to the φ-criterion using the statistical analysis software package STATISTICA v. 10 and Microsoft Office Excel application. Results. The results of the questionnaire determined that 44 (48.89 %) patients of the I group and 33 (47.14 %) women of the II group had disorders related to anxiety, and 6 (6.67 %) and 5 (7 .14 %) of the patients of both groups, respectively, were diagnosed depression before surgical treatment. After hysterectomy the number of patients with an anxiety disorder increased to 52 (57.78 %) in the I group and 41 (52.57 %) – II group, with depression – to 10 (11.11 %) and 8 (11.43 %) women, respectively. However, the psychopathological analysis with psychologists in 12 months after hysterectomy determined affective symptoms in 11 (15.7±7.0 %), and latent depression with a somatopsychic correlation, manifested by a feeling palpitation, cardialgias, vegetative disorders was found in 8 (11.4±6.0 %) cases. The type of personality accentuation influenced the development of psychoemotional manifestations. In this structure, the largest rate consisted of psychoasthenic and hysterical character traits. The age of the patient was important when analyzing additional psychological factors. Women under 44 years old associated hysterectomy with loss of femininity with premature aging of the organism. The patients with successful implementation of their role in the family and society had better postoperative psychological adaptation.Conclusions. There is a trend toward an increased number of anxiety and depressive disorders after hysterectomy in women with leiomyoma. After 12 months, affective symptoms were present in 11 (15.7±7.0 %) cases and in 8 (11.4±6.0 %) cases – hidden depression. Postoperative rehabilitation should include a consultation with a psychologist to identify and treat borderline mental disorders, which will lead to the initiation of compensatory and adaptive reactions of the body and the normalization of the psycho-emotional status.