TABLE 1.

Cumulative incidence of mental health conditions overall and in strata by age at hysterectomy with ovarian conservation

	Hysterectomy			Referent women			Unadjusted models^a		Adjusted models^b
Condition	N at risk	Person-years	N of events	N at risk	Person-years	N of events	Hazard ratio (95% CI)	P	Hazard ratio (95% CI)	P

Overall
Depression	1,872	32,540	636	1,950	33,418	506	1.29 (1.15–1.44)	<0.001	1.26 (1.12–1.41)	<0.001
Anxiety	1,941	35,279	554	1,992	35,252	423	1.31 (1.16–1.48)	<0.001	1.22 (1.08–1.38)	0.001
Substance abuse disorders	2,054	43,065	104	2,069	40,905	65	1.51 (1.11–2.04)	0.008	1.35 (0.99–1.85)	0.06
Dementia	2,089	44,221	143	2,091	41,396	132	0.98 (0.78–1.24)	0.87	0.94 (0.74–1.19)	0.59
Schizophrenia and psychosis	2,087	44,356	51	2,082	41,447	47	0.99 (0.67–1.46)	0.94	0.93 (0.62–1.39)	0.73
Age 18–35 years
Depression	483	7,969	189	511	8,512	130	1.54 (1.23–1.92)	<0.001	1.47 (1.17–1.86)	0.001
Anxiety	494	8,651	168	518	9,084	106	1.67 (1.31–2.11)	<0.001	1.45 (1.12–1.88)	0.005
Substance abuse disorders	520	10,820	41	523	10,201	22	1.74 (1.05–2.90)	0.03	1.27 (0.70–2.29)	0.44
Dementia	529	11,363	15	529	10,487	12	1.24 (0.59–2.58)	0.57	0.66 (0.29–1.53)	0.33
Schizophrenia and psychosis	528	11,397	3	529	10,526	4	0.68 (0.15–3.03)	0.61	0.73 (0.15–3.50)	0.69
Age 36–50 years
Depression	1,140	20,467	377	1,190	21,095	304	1.28 (1.10–1.48)	0.001	1.25 (1.07–1.45)	0.004
Anxiety	1,192	22,253	332	1,225	22,213	278	1.19 (1.02–1.39)	0.03	1.11 (0.94–1.30)	0.21
Substance abuse disorders	1,265	27,234	53	1,279	26,143	31	1.64 (1.06–2.54)	0.03	1.43 (0.90–2.25)	0.13
Dementia	1,294	28,068	51	1,293	26,583	34	1.44 (0.94–2.22)	0.09	1.37 (0.89–2.12)	0.15
Schizophrenia and psychosis	1,290	28,003	27	1,288	26,486	17	1.52 (0.84–2.74)	0.17	1.34 (0.74–2.45)	0.33
Age >50 years
Depression	249	4,104	70	249	3,812	72	0.90 (0.65–1.24)	0.51	0.91 (0.65–1.28)	0.59
Anxiety	255	4,375	54	249	3,954	39	1.22 (0.82–1.82)	0.33	1.21 (0.80–1.85)	0.37
Substance abuse disorders	269	5,012	10	267	4,561	12	0.74 (0.33–1.65)	0.46	0.86 (0.37–1.98)	0.72
Dementia	266	4,790	77	269	4,326	86	0.77 (0.57–1.04)	0.08	0.81 (0.59–1.10)	0.18
Schizophrenia and psychosis	269	4,956	21	265	4,435	26	0.69 (0.39–1.22)	0.21	0.71 (0.39–1.28)	0.25

Hazard ratios calculated using Cox proportional hazards models with age as the time scale.

Hazard ratios calculated using Cox proportional hazards models with age as the time scale and adjusted using inverse probability weights derived from a logistic regression model including all 20 chronic conditions present at baseline (index date), years of education (≤12, 13–16, >16, unknown), race (white vs nonwhite), and age and calendar year at baseline (continuous). These adjustments were performed separately in each stratum to maximize the balance at baseline. Overall interactions by age (18–35, 36–50, >50 years) were assessed for each mental health condition: depression P=0.002, anxiety P=0.28, substance abuse disorders P=0.20, dementia P=0.81, and schizophrenia and psychosis P=0.68.