Glavnyy Vrach Yuga Rossii · 2026
BORDERLINE MENTAL DISORDERS IN GYNECOLOGICAL PATIENTS OF REPRODUCTIVE AGE AND POSTMENOPAUSE, CONSIDERING AGE AND SOMATIC COMORBIDITY
By Ziganshin Aydar Mindiyarovich, Nasyrova Svetlana Fanilevna, Kulavskiy Evgeniy Vasilevich et al.
The aim of the study was to evaluate the structure and severity of borderline mental disorders in gynecological patients of reproductive age and postmenopause, taking into account age and somatic comorbidity. Materials and Methods. A retrospective analysis of 50 clinical cases was conducted in two study groups: those of reproductive age (n = 27, 19–51 years, median 29 years) and those in the postmenopausal period (n = 23, 51–89 years, median 68 years). Gynecological diagnoses and psychiatric codes (F) for sleep parameters and anxiety-depressive symptoms were assessed using a computer program (certificate no. 2026614516) that is at the validation stage, therefore the obtained data are interpreted as indicative. Statistical analysis of the data included the Mann-Whitney U-test, Fisher's exact test, logistic regression, and Bonferroni correction (α = 0.0033). Results. Anxiety disorders with autonomic paroxysms (52.2% versus 0% in reproductive age, p < 0.001, V = 0.64) and sleep maintenance disorders (95.7% versus 55.6%, p = 0.002, V = 0.48) were more frequently recorded in postmenopause. However, after controlling for age, hypertension, and social isolation, menopausal status ceased to be an independent predictor of anxiety (odds ratio 1.5; 95% confidence interval 0.5–4.3; p = 0.47). In reproductive age, there were more frequent tendencies toward more frequent personality disorders (22.2 vs. 0%, p = 0.025, after Bonferroni adjustment p > 0.05), anhedonia (55.6 vs. 17.4%, p = 0.006, not significant after adjustment), and nightmares (40.7 vs. 4.3%, p = 0.002, remains significant). All 12 patients with postmenopausal vaginal atrophy (N95.2) had sleep maintenance disorder, but due to the lack of a postmenopausal control group, a causal relationship was not established. Conclusion. In the studied cohort of gynecological patients, the differences in the pattern of borderline mental disorders between age groups were largely explained by age, vascular comorbidity, and social factors, rather than menopausal status per se. The term "postmenopausal anxiety syndrome" requires caution when used without controlling for vascular comorbidity. These findings require confirmation in prospective studies with validated scales.