Psychological Problems Experienced by Patients with Bowel Endometriosis Awaiting Surgery

Abstract

Objective To assess the most common psychological disturbances in women with deep endometriosis and bowel involvement who are waiting surgical treatment and to evaluate what forms of coping are used to solve the problem.

Methods This was a cross-sectional observational study of 40 women diagnosed with deep endometriosis and intestinal symptoms. They completed two questionnaires: one for anxiety and depression (Hospital Anxiety and Depression Scale [ HADS]) and the Scale of Mode of Confronting Problems (EMEP, in the Portuguese acronym).

Results We found that 77.1% of the patients had anxiety and depression, with anxiety being the most prevalent (87.5% of the patients); 90% of the patients used problem-focused and religious introspection as their main modes of confronting problems.

Conclusion In the use of the HADS questionary, two psychological aspects were the most present in women with deep endometriosis awaiting surgical treatment: anxiety and depression. The most used forms of coping to solve the problem were problem-coping and religious practices.

Resumo

Objetivo Avaliar os distúrbios psicológicos mais comuns em mulheres com endometriose profunda e acometimento intestinal que aguardam tratamento cirúrgico e avaliar as formas de enfrentamento que são usadas para resolver o problema.

Métodos Estudo observacional transversal com 40 mulheres com diagnóstico de endometriose profunda e acometimento intestinal. As pacientes responderam dois questionários: para ansiedade e depressão (Hospital Anxiety and Depression Scale [HADS, na sigla em inglês) e outro para enfrentamento dos problemas (EMEP).

Resultados Constatamos que 77% das pacientess apresentaram ansiedade e depressão, sendo a ansiedade a mais prevalente (87,5%); 90% das pacientes usaram a forma religiosa e focada no problema como sua principal estratégia de enfrentamento.

Conclusão Os aspectos psicológicos mais encontrados em mulheres com endometriose profunda e intestinal que aguardam tratamento cirúrgico são ansiedade e depressão. As formas mais usadas de enfrentamento para resolver o problema foram práticas religiosas e focada no problema.

Keywords

cross-sectional studies - endometriosis - depressive disorders - anxiety disorders - psychological adaptation

Palavras-chave

estudo transversal - endometriose - transtorno depressivo - transtorno de ansiedade - adaptacão psicológica

Contributions

All authors participated in the concept and design of the present study; analysis and interpretation of data; draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.

Publikationsverlauf

Eingereicht: 19. August 2020

Angenommen: 05. August 2021

Artikel online veröffentlicht:
20. Oktober 2021

• References

• 1 Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R. et al; ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod 2005; 20 (10) 2698-2704
• 2 Gordts S, Koninckx P, Brosens I. Pathogenesis of deep endometriosis. Fertil Steril 2017; 108 (06) 872-885.e1
• 3 Meuleman C, D'Hoore A, Van Cleynenbreugel B, Beks N, D'Hooghe T. Outcome after multidisciplinary CO2 laser laparoscopic excision of deep infiltrating colorectal endometriosis. Reprod Biomed Online 2009; 18 (02) 282-289
• 4 Giudice LC. Clinical practice. Endometriosis. N Engl J Med 2010; 362 (25) 2389-2398
• 5 Farquhar CM. Extracts from the “clinical evidence”. Endometriosis. BMJ 2000; 320 (7247): 1449-1452
• 6 Osório FL, Carvalho AC, Donadon MF, Moreno AL, Polli-Neto O. Chronic pelvic pain, psychiatric disorders and early emotional traumas: Results of a cross sectional case-control study. World J Psychiatry 2016; 6 (03) 339-344
• 7 Denny E. Women's experience of endometriosis. J Adv Nurs 2004; 46 (06) 641-648
• 8 Fauconnier A, Chapron C. Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications. Hum Reprod Update 2005; 11 (06) 595-606
• 9 Daraï E, Coutant C, Bazot M, Dubernard G, Rouzier R, Ballester M. [Relevância dos questionários de qualidade de vida em mulheres com endometriose] [Artigo em francês]. Gynecol Obstet Fertil Março de 2009; 37 (03) 240-245 . PMID: 19246235//DOI: 10.1016 / j.gyobfe.2008.11.014
• 10 Fourquet J, Báez L, Figueroa M, Iriarte RI, Flores I. Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity. Fertil Steril 2011; 96 (01) 107-112
• 11 Laganà AS, La Rosa VL, Rapisarda AMC, Valenti G, Sapia F, Chiofalo B. et al. Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health 2017; 9: 323-330
• 12 Donatti L, Ramos DG, Andres MP, Passman LJ, Podgaec S. Patients with endometriosis using positive coping strategies have less depression, stress and pelvic pain. Einstein (Sao Paulo) 2017; 15 (01) 65-70
• 13 Peveler R, Edwards J, Daddow J, Thomas E. Psychosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain. J Psychosom Res 1996; 40 (03) 305-315
• 14 Mengarda CV, Passos EP, Picon P, Costa AF, Picon PD. [Validation of Brazilian Portuguese version of quality of life questionnaire for women with endometriosis (Endometriosis Health Profile Questionnaire–EHP-30)]. Rev Bras Ginecol Obstet 2008; 30 (08) 384-392 Portuguese
• 15 Donnez J, Nisolle M, Smoes P, Gillet N, Beguin S, Casanas-Roux F. Peritoneal endometriosis and “endometriotic” nodules of the rectovaginal septum are two different entities. Fertil Steril 1996; 66 (03) 362-368
• 16 Sekula VG. Impacto do tratamento cirúrgico laparoscópico na qualidade de vida de mulheres portadoras de endometriose profunda [dissertação]. São Paulo: Faculdade de Ciências Médicas da Santa Casa de São Paulo; 2010
• 17 Nnoaham KE, Hummelshoj L, Webster P, d'Hooge T, Nardone FC, Nardone CC. et al; World Endometriosis Research Foundation Global Study of Women's Health consortium. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 2011; 96 (02) 366-373.e8
• 18 Sepulcri RdeP, do Amaral VF. Depressive symptoms, anxiety, and quality of life in women with pelvic endometriosis. Eur J Obstet Gynecol Reprod Biol 2009; 142 (01) 53-56
• 19 Minson FP, Abrão MS, Sardá Júnior J, Kraychete DC, Podgaec S, Assis FD. [Importance of quality of life assessment in patients with endometriosis]. Rev Bras Ginecol Obstet 2012; 34 (01) 11-15
• 20 Ballard KD, Seaman HE, de Vries CS, Wright JT. Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study–Part 1. BJOG 2008; 115 (11) 1382-1391
• 21 American Society of Reproductive Medicine. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 1997; 67 (05) 817-821
• 22 De Cicco C, Corona R, Schonman R, Mailova K, Ussia A, Koninckx P. Bowel resection for deep endometriosis: a systematic review. BJOG 2011; 118 (03) 285-291
• 23 Fleck MP, Berlim MT, Lafer B, Sougey EB, Del Porto JA, Brasil MA. et al. [Review of the guidelines of the Brazilian Medical Association for the treatment of depression (Complete version)]. Br J Psychiatry 2009; 31 (Suppl. 01) S7-S17
• 24 Abrão MS, Nogueira AP, Petta CA, Ferriani RA. New theory about etiopathogeny of endometriosis. Femina 2000; 28 (08) 429-434 , set. 2000. ilus. lil-275944
• 25 Koninckx PR, Ussia A, Adamyan L, Wattiez A, Donnez J. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril 2012; 98 (03) 564-571
• 26 Botega NJ, Bio MR, Zomignani MA, Garcia JrC, Pereira WA. Transtornos do humor entre pacientes internados em ambulatório e validação da escala de ansiedade e depressão HAD. Rev Saude Publica, outubro de 1995; 29 (05) 355-363
• 27 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67 (06) 361-370
• 28 Vitaliano PP, Russo J, Carr JE, Maiuro RD, Becker J. The ways of coping checklist: revision and psycho-metric properties. Multivariate Behav Res 1985; 20 (01) 3-26
• 29 Gimenes MG, Queiroz B. As diferentes fases de enfrentamento durante o primeiro ano após a mastectomia. In: Gimenes MG, Fávero MH. organizadores. A mulher e o câncer. Campinas: Editorial Psy; 1997: 171-195
• 30 Bedaiwy MA, Allaire C, Yong P, Alfaraj S. Medical management of endometriosis in patients with chronic pelvic pain. Semin Reprod Med 2017; 35 (01) 38-53
• 31 Siedentopf F, Tariverdian N, Rücke M, Kentenich H, Arck PC. Immune status, psychosocial distress and reduced quality of life in infertile patients with endometriosis. Am J Reprod Immunol 2008; 60 (05) 449-461