Gynaecological health in women with delusional disorder: A cross-sectional and one-year follow-up study

Abstract

Introduction: For many decades, clinical and epidemiological associations between gynaecological illness and psychia-
tric disorders have been reported. Thus, in recent years, special attention has been paid to the gynaecological health of women with chronic psychosis.We aimed to determine the rates of oestrogen and non-oestrogen dependent gynae-
cological disorders in women diagnosed with delusional disorder (DwDD), and its relationship with clinical outcomes.

Methods: We conducted a longitudinal and observational study in 90 women DwDD who attended our Department of Psychiatry, from 2000 until 2013. Subjects were selected by consecutive sampling and followed-up for one year. The presence or absence of inflammatory and non inflammatory-gynaecological disorders was recorded according to ICD-10 criteria, and attendance rates at appointments (psychiatric and nursing) were collected. For comparisons, T and Chi-square tests were performed. Multinomial logistic regression was applied to investigate multivariate differences.

Results: Thirty-six (40%) women DwDD had a history of gynaecological disease (oestrogen dependent disorders: 36.7%). Women diagnosed with a gynaecological disease had higher unemployment rates than those without gynae-
cological conditions (p = .03). Patients without gynaecological disorders attended later our psychiatric service and were more frequently admitted (p = .048). Within the gynaecological group, leiomyoma of uterus (n = 9; 10%) was the most common condition followed by misscarriage (n = 6; 6.7%). Hysterectomy (n = 7; 7.8%) was the most common surgical treatment. After one year, women diagnosed with gynaecological illness showed a tendency to lower rates of affective comorbidity and less antidepressant prescription. After controlling for age at first appointment and admissions, differences in affective comorbidity remained significant (p = .020); however, differences in antidepressant prescription and employment status were no longer significant.

Conclusions: Women DwDD might be at particular risk of non-inflammatory oestrogen dependent gynaecological disorders. The role of mental health nurses should be addressed to improve attendance rates at gynaecological appoint-
ments and prevention programs.