{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:29:25Z","timestamp":1765758565101},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T00:00:00Z","timestamp":1568160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To measure depression over time using the Patient Health Questionnaire 9 (PHQ\u20109) and identify characteristics associated with persistent depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A database of women undergoing obstetric fistula repair was used to examine associations between depression and variables such as demographics, type of fistula, and postoperative continence status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 797 patients completed the PHQ\u20109 at the initial preoperative assessment; 365 (45.8%) had a PHQ\u20109 score of 5 or higher, indicating depression. Preoperatively, depression was associated with women aged 18\u201334\u00a0years, with no children, and with fistula for 5\u00a0years or less. Postoperatively, depression was associated with persistent incontinence. Over time, however, depression was rarely found among women returning for follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Postoperative depression decreased over time in women who returned for follow\u2010up, either due to selection bias or due to improved adjustment to one's circumstances. This study underscores the need for ongoing follow\u2010up, especially for those not presenting for care or with persistent incontinence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12945","type":"journal-article","created":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T05:59:32Z","timestamp":1566021572000},"page":"206-211","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Persistent depression after obstetric fistula repair"],"prefix":"10.1002","volume":"147","author":[{"given":"Mary J.","family":"Stokes","sequence":"first","affiliation":[{"name":"Division of Global Women's Health Department of Obstetrics and Gynecology Baylor College of Medicine  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey P.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Division of Global Women's Health Department of Obstetrics and Gynecology Baylor College of Medicine  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prakash","family":"Ganesh","sequence":"additional","affiliation":[{"name":"International Training and Education Center for Health (I\u2010TECH) University of Washington  Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Nundwe","sequence":"additional","affiliation":[{"name":"Fistula Care Center  Lilongwe Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel J.","family":"Pope","sequence":"additional","affiliation":[{"name":"Division of Global Women's Health Department of Obstetrics and Gynecology Baylor College of Medicine  Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,9,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.10 facts on obstetric fistula[WHO website].2014.http:\/\/www.who.int\/featu\u200bres\/factf\u200biles\/obste\u200btric_fistu\u200bla\/en\/. 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