Demographics and Hospital Outcomes in American Women With Endometriosis and Psychiatric Comorbidities.

Chris A Robert,Sasank Isola,Emmanuelle J Caraballo-Rivera,Sabiha Akter,Rikinkumar S Patel,Shikha Verma,Kosisochukwu Oraka

doi:10.7759/cureus.9935

Abstract

ObjectivesTo explore sociodemographic differences and hospital outcomes in endometriosis patients with versus without psychiatric comorbidities.MethodsWe conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS, 2012-2014), and included 63,160 females with primary diagnosis of endometriosis. We used descriptive statistics and Pearson’s chi-square test to measure the differences in demographics and utilization of gynecologic procedures by the presence of psychiatric comorbidities.ResultsPsychiatric comorbidities were present in 18.7% inpatients with endometriosis. About three-fourth of these inpatients were in reproductive age group 26-45 years (75.7%) and were whites (79.1%). Psychiatric comorbidities were seen more in females from middle-income families and from the midwest region of the US. There was no significant difference in the utilization of gynecological procedures by the presence of psychiatric comorbidities. However, inpatients with psychiatric comorbidities had a longer mean length of stay (2.5 vs. 2.3 days) and total charges ($35,489 vs. $34,673) compared to the non-psychiatric cohort. Anxiety disorders predominated at 45% in patients with endometriosis followed by depressive disorder (31.3%), psychotic disorders (12.3%), and drug abuse (6.3%).ConclusionEndometriosis with psychiatric comorbidities is prevalent in young white females from a middle-income family. Anxiety and depressive disorders are most prevalent and are associated with extended hospitalization stay and higher charges, thereby negatively impacting the healthcare burden compared to those without psychiatric comorbidities.

Highlights

Endometriosis is an estrogen-dependent chronic disorder characterized by the presence of endometrial type glands and stroma outside the uterus [1]
There was no significant difference in the utilization of gynecological procedures by the presence of psychiatric comorbidities
Anxiety disorders predominated at 45% in patients with endometriosis followed by depressive disorder (31.3%), psychotic disorders (12.3%), and drug abuse (6.3%)

Summary

Introduction

Endometriosis is an estrogen-dependent chronic disorder characterized by the presence of endometrial type glands and stroma outside the uterus [1]. There is an elevated risk of depression and anxiety in women with endometriosis [3,4,5] This may be attributed to the consequences of endometriosis, such as chronic pelvic pain, infertility, and subfertility [6]. Endometriosis is often diagnosed later in the disease process, and this may further amplify the psychological suffering in these women and lead to psychiatric disorders [7]. Since both endometriosis and psychiatric disorders are heritable, familial risk factors could explain the connection [8]

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