Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Psychosomatic obstetrics and gynecology –- a neglected field? Prabha S. Chandra a and Sanjeev Ranjan b Purpose of review The purpose of the review was to evaluate recent studies in the field of psychosomatic obstetrics and gynecology for new directions in research. Recent findings Psychosomatic obstetrics and gynecology covers a wide canvas, and the present review shows extensive research in some areas and large gaps in others. There have been significant developments in the field of pregnancy-related psychiatric morbidity, particularly anxiety states and posttraumatic stress disorder; however, there is a need for better and more specific measurement and screening methods. Among gynecological conditions there have been advances in research on chronic pelvic pain and gynecological cancers, but most other gynecological conditions have been neglected. What is encouraging is the increasing amount of research from the developing world and the focus on common reproductive conditions based on community studies. In addition, in light of the recent findings and concerns related to hormone replacement therapy, research on mood disorders related to menopause is increasing, with refinement in measurements, definitions, and treatment methods. Summary While studies on prevalence and risk factors abound, what is missing are well conducted intervention studies. The next phase of research should focus on preventive and intervention studies that are easily adaptable the world over. Keywords gynecology, mental health, pregnancy, reproductive health, women Curr Opin Psychiatry 20:168–173. ß 2007 Lippincott Williams & Wilkins. a National Institute of Mental Health and Neurosciences, Bangalore, India and b Glenside Mental Health Campus, Adelaide, South Australia Correspondence to Prabha S. Chandra, Professor of Psychiatry, NIMHANS, Bangalore 560029, India Tel: +91 80 26995272; fax: +91 80 26564830; e-mail: prabhasch@gmail.com and/or chandra@nimhans.kar.nic.in Conflict of Interest: None Current Opinion in Psychiatry 2007, 20:168–173 Abbreviations CPP chronic pelvic pain ERT estrogen replacement therapy PCOS polycystic ovarian syndrome PTSD posttraumatic stress disorder ß 2007 Lippincott Williams & Wilkins 0951-7367 Introduction The interface between obstetrics/gynecology and mental health has been a subject of research for the past three decades. Each era in the history of this field has focused on different conditions at different points in time. It appears that topics of interest change depending on women’s needs, advances in surgical and medical treat- ment and sociopolitical, demographic, and cultural issues that influence women’s lives. The present review attempts to cover and critically evaluate some of the most important research in the field that has direct application in the treatment and manage- ment of this important interface. While the review attempts to be comprehensive, we chose to focus on specific areas that have not been covered in other reviews, and we have deliberately not covered some areas (e.g. postpartum depression) that in our opinion have been extensively reviewed in other papers. The review has three sections. The first part focuses on psychosomatic issues in commonly encountered gyneco- logical conditions, including gynecological cancers; the second part considers childbirth-related psychological conditions, including abortion and infertility; and the final section covers menopause-related psychosomatic issues. Common gynecological conditions and psychiatric morbidity While most gynecological problems have been found to be associated with psychosocial stress, certain conditions have been studied more than others due to the extent and nature of the condition. Hysterectomy Most studies in this area have now improved on the earlier methodological problems involving design, sampling, and measurement. Both mood symptoms and sexual functioning have been studied extensively. There is little evidence to suggest that hysterectomy alone results in problems in sexual functioning. Con- trolled studies do not find impairments in mood or overall psychological functioning of hysterectomized (without oophorectomy) women, except for some data that abdominal hysterectomy may be associated with poorer body image [1  ]. A recent randomized controlled trial [2  ] comparing outcomes in women undergoing two types 168