Study did not reliably exclude possibility of psychological damage

EDITOR,—David A Alexander and colleagues conclude that there is no evidence that hysterectomy leads to postoperative psychiatric illness and that endometrial ablation and hysterectomy have a similar effect on psychiatric outcome.1 Their conclusion rests heavily on the appropriateness of the main instrument used to explore psychiatric outcome. They used the hospital anxiety and depression scale. This is a useful screening instrument, and it is also a good way of monitoring change in established depressive illnesses or …