Design: Prospective cohort study of women undergoing hysterectomy.

Setting: Academic tertiary medical center.

Patients or Participants: 456 women who underwent hysterectomy for benign indications.

Interventions: N/A

Measurements and Main Results: Women were contacted by phone 2 weeks before their scheduled hysterectomy for a baseline interview. Participants were then contacted again 1, 4, and 6 weeks and 3, 6, and 12 months post-surgery to complete validated questionnaires. The exposure of interest was anxiety/depression prior to hysterectomy, defined based on one of the EuroQol-5D-3L dimensions. The primary outcome was pattern of regret through the year post-hysterectomy, defined by latent class analysis. A total of 3 classes were identified: Class 1: High Regret (high regret at baseline that did not improve over time; 34 (7.4%)), Class 2: Decreasing Regret (high regret at baseline but improved over time; 61 (13.4%)) and Class 3: Least Regret (low baseline regret that remained low over time; 361 (79.2%)). Relative to women who were not anxious or depressed, those who were moderately anxious or depressed were 2.53 times as likely to be in the High Regret class relative to the Least Regret class (Risk Ratio (2.53 [1.17, 5.50]). Additionally, those who were extremely anxious or depressed were 3.1 times as likely to be in the Decreasing Regret class (RR [95% CI] = 3.10 [1.41, 6.80]).

Conclusion: Specific comparisons revealed that anxiety/depression prior to hysterectomy was associated with increased probability of High Regret and Decreasing Regret. Surgeons may wish to consider each patient’s level of anxiety and depression when conducting pre-surgical counseling.