Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain.

Lilian Donatti,Sérgio Podgaec,Marina De Paula Andres,Leigh Jonathan Passman,Denise Gimenez Ramos

doi:10.1590/s1679-45082017ao3911

Abstract

ABSTRACTObjective To determine the correlations between coping strategies, depression, stress levels and pain perception in patients with endometriosis.Methods This prospective and exploratory study included 171 women undergoing treatment for endometriosis between April and August 2014. The questionnaires used were Brief COPE, Beck Depression Inventory, Lipp’s Stress Symptom Inventory for Adults and Visual Analogue Scale. Clinical data were collected from electronic medical records.Results Patients with endometriosis who used positive coping strategies had better adaptation to stress (p<0.004) and less depression (p<0.004). The presence and intensity of depression, stress and acyclic pelvic pain were directly associated (p<0.05). The intensity of dysmenorrhea was associated with the degree of depression (p<0.001), whereas acyclic pelvic pain was associated with the degree of depression (p<0.001), stress level (p<0.001) and stress type (p<0.001).Conclusion We found a positive association between coping, depression levels, type and levels of stress and pain intensity in patients with endometriosis. The use of maladaptive coping strategies focused on emotion is correlated with increase in depression and stress.

Highlights

Endometriosis is a chronic inflammatory disease featured by presence of endometrial cells outside the uterine cavity
A number of studies have approached the subject of endometriosis, but they observe a gap in the psychological aspect of the disease.[1]. Treatment of emotional symptoms along with physical symptoms might bring great benefits and it may constitute the most powerful therapeutic result.[12]. Based on psychosomatic theory, it is impossible to differentiate influence that mind causes in the body and vice-versa, this is an unique and indissoluble proportion.[12] a tendency exists to consider psychosomatic all diseases as they involve the continuous inter-relation between body and mind in its origin, development and healing
42.7% had infertility, 87.1% dysmenorrhea and 90.6% chronic pelvic pain, and this last was classified as severe (VAS >7) in 39.8%

Summary

Introduction

Endometriosis is a chronic inflammatory disease featured by presence of endometrial cells outside the uterine cavity. Donatti L, Ramos DG, Andres MP, Passman LJ, Podgaec S diagnosis is fundamental in order to ameliorate suffering and distress of waiting for answers and treatment plans. For this reason, the clinical evaluation, followed by specific image exams such as transvaginal ultrasound with intestinal preparation, enables experts to define an adequate therapeutic strategy.[15]. Studies approaching psychological perspective of endometriosis deal with issues such as patients’ poor quality of life,(10,14,16-18) including harms in interpersonal and affective relationships;(6,16) difficulties in sexuality;(9,19) professional losses;(10,11) depression and anxiety;(3,7,20) suffering facing the recognition of healing difficulties;(21) ways for facing the disease;(4) constant presence of pain and stress;(4,5,22,23) importance of therapy and group support;(3,5,12-14) and other complementary therapies in which the objetive is to reduce pain and anxiety, such as acunputure and relaxing techniques,(24,25) exercises[26] and changes in eating habits.[1].

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Results

Conclusion