Bilateral oophorectomy amplifies depression risk following hysterectomy NHANES 2006-2017

This study aims to evaluate the association between hysterectomy with bilateral salpingo-oophorectomy (HBSO) and depressive symptoms, exploring the impact of different surgical approaches on the severity of depression. Data from the 2006-2017 National Health and Nutrition Examination Survey (NHANES) were used to analyze the relationship between surgical methods and depressive symptoms.This study analyzed data from 10,780 women aged 20-80 years, with a diverse racial composition: 44.2% non-Hispanic White, 20.4% non-Hispanic Black, 14.7% Mexican American, 11.0% Other Hispanic, and 9.7% Other Race.The Patient Health Questionnaire-9 (PHQ-9), a validated depression screening tool, was utilized to assess depressive symptoms. Multivariable linear regression and binary logistic regression analyses were conducted to evaluate the association between surgical approaches and depressive symptoms, with results presented as odds ratios (OR) and their 95% confidence intervals (CI). Subgroup analyses employed stratified regression models to investigate interactions between baseline characteristics and surgical methods. Demographic analysis showed differences in age, marital status, education, income, smoking, BMI, and chronic disease prevalence between the depressive and non-depressive groups. HBSO was significantly associated with higher PHQ-9 scores and a higher likelihood of significant depressive symptoms (PHQ-9 ≥ 10). Hysterectomy was also associated with depressive symptoms, but to a lesser extent. Further analysis revealed that hysterectomy was significantly associated with higher depressive scores, particularly in the PHQ-9 ≥ 20 group. Subgroup analysis indicated significant interaction effects between surgical types and factors such as BMI, Income-to-Poverty Ratio (IPR), smoking, and alcohol consumption. The findings suggest a significant association between hysterectomy, particularly HBSO, and the severity of depressive symptoms. Lifestyle and behavioral factors, such as BMI, smoking, and alcohol consumption, significantly influence the occurrence of postoperative depression. Thorough evaluation of patients' psychological health and related factors is essential when considering gynecological surgery.