Patients with psychiatric disorders in gynecologic practice

Objective: The relationship between different gynecologic complaints and somatic symptoms was studied in a gynecologic population in which the prevalence of psychiatric disorders had been established. Study Design: The prevalence of depression and anxiety in the unselected population of 1013 subjects was 27.2% and 12.1%, respectively, as assessed by the Primary Care Evaluation of Mental Disorders (PRIME-MD). The subjectsʹ medical charts were reviewed after the PRIME-MD diagnosis was made. Results: Depression and anxiety disorders were significantly more common among those seeking care for abdominal pain, those who made frequent and unscheduled visits, and those who were hospitalized for acute care. All the physical symptoms indicated in the PRIME-MD Patient Health Questionnaire were more common among women with a psychiatric diagnosis compared with controls. Conclusions: The majority of cases of depression and anxiety in women are undiagnosed and untreated, and patients with these disorders often present with physical symptoms. Because gynecologic outpatients with abdominal pain, frequent and unscheduled visits, and admissions due to acute illness are more likely to have a psychiatric disorder, it is desirable that gynecologists recognize and treat these problems. (Am J Obstet Gynecol 2001;185:396-402)