Psychiatric disorders tied to unnecessary oophorectomy

Preexisting mood, anxiety and somatoform disorders were linked to an increased risk for bilateral oophorectomy over a 20-year period, even after confirmation of a nonmalignant diagnosis, according to results published in Menopause.

“A formal study of psychiatric conditions before bilateral oophorectomy has not been conducted,” Liliana Gazzuola Rocca, MD, from the division of epidemiology at Mayo Clinic, and colleagues wrote. “Even though psychiatric symptoms or adverse experiences are not an indication for bilateral oophorectomy, these conditions may have directly or indirectly influenced the decision.”

Rocca and colleagues examined the association between preexisting mental health conditions and oophorectomy in premenopausal women who underwent bilateral oophorectomy for a nonmalignant indication between 1988 and 2007.

The researchers identified 1,653 cases and 1,653 age-matched controls after reviewing medical records in a population-based records-linkage system. After adjusting for race, education and income, they calculated the risk for mood disorders, bipolar disorders, anxiety disorders, schizophrenia, somatoform disorders, personality disorders, dissociative disorders and adjustment disorders.

 

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Overall analyses indicated that somatoform disorders (OR = 3.65, 95% CI, 1.75-7.64), mood disorders (OR = 1.77; 95% CI, 1.51-2.09) and anxiety disorders (OR = 1.29; 95% CI, 1.04-1.59) were linked to a greater risk of bilateral oophorectomy. The association for somatoform disorders was particularly strong in women aged 45 years and younger (OR = 5.09; 95% CI, 1.75-14.86), according to the data.

Rocca and colleagues also reported a linear trend of increasing risk for oophorectomy depending on the number of psychiatric conditions present (OR = 1.55; 95% CI, 1.31-1.83 for one condition to OR = 2.19; 95% CI, 1.4-3.41 for three or more).

Analyses stratified by indication revealed that mood disorders were linked to a greater risk of bilateral oophorectomy both in women with an ovarian indication (OR = 1.69; 95% CI, 1.31-2.18) and without (OR = 1.86; 95% CI, 1.5-2.3). In contrast, anxiety disorders and adjustment disorders were tied to an increased risk only in the group without an ovarian indication, while bipolar disorders and somatoform disorders were linked only in the group with an ovarian indication.

“Understanding the psychiatric conditions that may have influenced the practice of hysterectomy with or without concurrent bilateral oophorectomy in the past is important for developing more conservative strategies in the future,” the researchers wrote. “For example, future practice could involve multidisciplinary teams able to help women address sensitive and emotional issues and to offer alternative treatment plans.” – by Savannah Demko

Disclosure: Rocca reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.