Mental health screening in women with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula in western Uganda

• Published in: International Urogynecology Journal 2017-06, Vol.28 (6), p.893-897
• Main Authors: Krause, Hannah G., Hall, Barbara A., Ng, Shu-Kay, Natukunda, Harriet, Singasi, Isaac, Goh, Judith T. W.
• Format: Article
• Language: English
• Subjects: Adult; Antiretroviral drugs; Delivery, Obstetric - adverse effects; Delivery, Obstetric - psychology; Depressive Disorder, Major - etiology; Female; Fistula - psychology; Genital Diseases, Female - psychology; Genitalia, Female - injuries; Gynecology; Health risk assessment; Humans; Medical screening; Medicine; Medicine & Public Health; Mental health; Middle Aged; Obstetrics; Original Article; Pelvic organ prolapse; Pelvic Organ Prolapse - psychology; Pregnancy; Prospective Studies; Risk Factors; Uganda; Urology; Vaginal Fistula - psychology; Womens health
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-016-3177-3

Introduction and hypothesis High levels of mental health dysfunction have been identified in women with genital tract fistula. The aim of this study was to use the General Health Questionnaire-28 (GHQ-28) to screen women in western Uganda with severe pelvic organ prolapse, chronic fourth-degree obstetric tear and genital tract fistula for risk of mental health dysfunction. Methods Women undergoing surgery for severe pelvic organ prolapse, chronic fourth-degree obstetric tear, and genital tract fistula were interviewed using the GHQ-28 to screen for the risk of mental health dysfunction. Results A total of 125 women completed the GHQ-28, including 22 with pelvic organ prolapse, 47 with fourth-degree obstetric tear, 21 with genital tract fistula, and 35 controls. Nearly all women with these serious gynaecological conditions were positive for the risk of mental health dysfunction. In the domain assessing symptoms of severe depression, women with fourth-degree obstetric tear and genital tract fistula scored higher than women with pelvic organ prolapse. Conclusions A significant risk of mental health dysfunction was identified in women with severe pelvic organ prolapse and chronic fourth-degree obstetric tear. These rates are similar to the high rates of mental health dysfunction in women with genital tract fistula. Identification and management of mental health dysfunction in women with these conditions should be a priority.