We studied eight mental health conditions diagnosed before bilateral oophorectomy performed for nonmalignant indications.
We identified 1,653 premenopausal women who underwent bilateral oophorectomy for a nonmalignant indication in Olmsted County, Minnesota, during a 20-year period (1988-2007). Each woman was matched by age (±1 year) to one population-based control who had not undergone bilateral oophorectomy before the index date (age range: 21-49 years). Both cases and controls were identified using the records-linkage system of the Rochester Epidemiology Project (REP http://www.rochesterproject.org). For eight mental health conditions, we calculated odds ratios (ORs) and their 95% confidence intervals (95% CIs) adjusted for race, education, and income using conditional logistic regression.
Pre-existing mood disorders, anxiety disorders, and somatoform disorders were associated with increased risk of bilateral oophorectomy in overall analyses. These associations were also significant in women ≤45 years of age at index date. Personality disorders were associated with increased risk only in overall analyses and adjustment disorders only in women 46 to 49 years of age. Some of the associations were significantly different across strata by age at index date and by indication. There was also a linear trend of increasing adjusted ORs from 1.55 (95% CI 1.31-1.83) for one mental health condition to 2.19 (95% CI 1.40-3.41) for three or more conditions (trend P < 0.001).
We identified several mental health conditions that were associated with bilateral oophorectomy for nonmalignant indications. Awareness of these associations may guide women and physicians in future decision-making and limit unindicated bilateral oophorectomies.
1Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
2Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
3Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
4Department of Surgery, Mayo Clinic, Rochester, MN
5Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN
6Division of Gynecology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN
7Department of Neurology, Mayo Clinic, Rochester, MN
8Women's Health Research Center, Mayo Clinic, Rochester, MN.
Address correspondence to: Walter A. Rocca, MD, Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail: firstname.lastname@example.org
Received 4 April, 2019
Revised 11 June, 2019
Accepted 11 June, 2019
Funding/support: The MOA-2 study used the resources of the Rochester Epidemiology Project, which was supported by the National Institute on Aging of the National Institutes of Health (grants R01 AG034676, and R01 AG052425). However, the content of this article is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health. This study was also supported by funds from the Mayo Clinic Research Committee (to W.A.R.). Dr. Rocca was partly supported by the National Institutes of Health (P50 AG044170, U01 AG006786, and P01 AG004875). Dr Bobo's research has been funded by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Mayo Foundation for Medical Education and Research.
Financial disclosure/conflicts of interest: Over the past 36 months, Dr Stewart received funding from AbbVie, Allergan, Bayer, Med Learning Group, Myovant, and Welltwigs, and received royalties from UpToDate for articles on uterine diseases. None of these activities were related to this manuscript. Dr Laughlin-Tommaso consults for Allergan, has a research grant from Bayer, is on the DSMB for the ULTRA trial (Halt Medical), and receives royalties from UpToDate for fibroid articles. Dr Bobo receives royalties from UpToDate for bipolar disorder articles. For the remaining authors, no disclosures were declared.
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