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Persistent depression after obstetric fistula repair
Author(s) -
Stokes Mary J.,
Wilkinson Jeffrey P.,
Ganesh Prakash,
Nundwe William,
Pope Rachel J.
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12945
Subject(s) - depression (economics) , medicine , demographics , patient health questionnaire , fistula , mental health , physical therapy , surgery , depressive symptoms , psychiatry , demography , anxiety , sociology , economics , macroeconomics
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.