Psycho-emotional status in patients with endometriosis-associated pain syndrome in various disease phenotypes

BACKGROUND: Patients with endometriosis-associated pain syndrome in combination with anxiety or depression have lower treatment effectiveness and satisfaction with both the disease itself and the pain syndrome compared to patients with pain syndrome but without depression or anxiety. AIM: The aim of the study is to assess the relationship between psychosocial status and endometriosis-associated pain syndrome in patients with different phenotypes of endometriosis using pain assessment scales, psychosocial state assessment scales, and quality of life assessment scales. MATERIALS AND METHODS: We examined 81 patients using a number of questionnaires: Visual Analogue Scale, Numeric Rating Scale, Hospital Anxiety and Depression Scale, Beck Depression Scale, Spielberger State-Trait Anxiety Inventory, and Short Form-36 quality of life assessment. The patients were divided into three groups: isolated adenomyosis (n = 39), adenomyosis combined with external genital endometriosis (n = 21), and the control group (n = 21). RESULTS: Our study has shown that patients with adenomyosis combined with external genital endometriosis had the highest scores on all questionnaires for assessing anxiety and depression, as well as a low quality of life in general, which significantly differed from those in the control group (p 0.05). The results in the group of women with isolated adenomyosis are not so unambiguous and, overall, somewhat better than in the group of patients with adenomyosis combined with external genital endometriosis, but significantly worse compared to the control group. When assessing the severity of dysmenorrhea, higher scores were also found in the group of women with adenomyosis combined with external genital endometriosis: 6.64 2.11 cm (Visual Analogue Scale) and 6.9 2.05 cm (Numeric Rating Scale), while in the group of women with isolated adenomyosis, the scores were 5.29 1.9 cm and 5.83 1.72 cm, respectively (p = 0.028). Women in the control group had no pain syndrome. CONCLUSIONS: Poor mental and physical health scores obtained in this study in women with external genital endometriosis dictate the need for an objective and multicomponent assessment of the psycho-emotional status in patients, followed by complex treatment and team management with related specialists.