Prevalence and Associated Factors of Depression among Women with Advanced Pelvic Organ Prolapse in Northwest Ethiopia

Abstract

Abstract Background Depressive disorders are characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. There is no adequate evidence of the burden of depression among women with pelvic organ prolapse and its associated factors in Ethiopia. This study was performed to determine the prevalence of depression among women with advanced pelvic organ prolapse and to identify factors associated with depression in these women. Methods A facility-based cross-sectional study was conducted among 367 women who were diagnosed with advanced pelvic organ prolapse at Gondar University Comprehensive Specialized Hospital. The data were collected from January 01 to April 30, 2023. To select a total of 367 participants, a consecutive sampling technique was applied by female trained BSC-midwives. A structured questionnaire was used to obtain sociodemographic characteristics and clinical characteristics of the participants. Depression measures were obtained by using the Patient Health Questionnaire (PHQ) tool, which is validated in Ethiopia, using a cut point of five and above, which is considered to indicate depressive symptoms. Women who screened positive were linked to a psychiatric clinic for further evaluation and treatment. Data were entered into a computer using Epi Info version 3.5.3 and then exported to STATA version 14 for analysis. Multivariable logistic regressions were fitted, and odds ratios with 95% confidence intervals with a P value less than 0.05 were used to identify statistically significant factors. Results The prevalence of depression was found to be 47.1% (95% CI: 43%-52%). Being rural (AOR = 4.8; CI: 1.11–16.32), having a history of divorce because of pelvic organ prolapse (AOR = 5.5; CI: 1.85–16.32) and having a history of urinary symptoms (AOR = 3.1; CI: 1.12–8.59) were found to be independently associated with depressive symptoms. Conclusions and recommendations: The prevalence of depressive symptoms among women with advanced pelvic organ prolapse in this study is high. Being a rural resident, being divorced because of pelvic organ prolapse and having urinary symptoms are independently associated with depressive symptoms. Depression screening strategies should be designed for the early identification and treatment of depression among women with advanced pelvic organ prolapse.