Psychiatric morbidity in a gynaecology clinic an epidemiological survey

Two hundred and eleven women between the ages of 18 and 65 years referred to a gynaecological out-patient clinic were screened for psychiatric disorder using the General Health Questionnaire (GHQ) and a Demographic Questionnaire. A random sub-sample of 35 women were interviewed using the Present State Examination (PSE) and the Brown and Harris Life Events and Difficulties Schedule (LEDS), and compared to a general population sample (N = 140) matched for life stage (LS) and social class. Forty six per cent of women in the clinic scored as cases on the GHQ. High scores were associated with being divorced, separated, or widowed, and with complaints of pelvic pain. PSE case rates were higher in the clinic sample than in the general population group (29 per cent and 17 per cent). Younger women (LS 1) and middle class women in the clinic sample had higher rates than in the general population. Only the middle class women in the clinic sample showed significantly higher rates for severely threatening life events and/or difficulties before onset of psychiatric disorder. The study supports the view that rates of psychiatric disorder are high among women referred to a gynaecology clinic and indicates the importance of associations with demographic factors and recent experience of life stress, especially marital difficulties.