Gayathri Delanerolle1, Rema Ramakrishnan2, Dharani Hapangama3,4, Yutian Zeng5, Ashish Shetty6,7, Sohier Elneil6,7, Sam Chong6,7, Martin Hirsch6,8, Molola Oyewole6,7, Peter Phiri9,10, Kathryn Elliot9, Trusha Kothari4, Bryony Rogers3,4, Natasha Sandle1, Nyla Haque1, Nicola Pluchino11, Martin Silem12, Rebecca O'Hara13, M Louise Hull13, Kingshuk Majumder14, Jian Qing Shi5,15, Vanessa Raymont1,16. 1. Oxford Brain Health Clinical Trials Unit, University of Oxford, Oxford, UK. 2. Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK. 3. University of Liverpool, Liverpool, UK. 4. Liverpool Women's NHS Foundation, Liverpool, UK. 5. Southern University of Science and Technology, Shenzhen, China. 6. University College London Hospitals NHS Foundation Trust, London, UK. 7. University College London, London, UK. 8. Oxford Health NHS Foundation Trust, Oxford, UK. 9. Southern Health NHS Foundation Trust, Southampton, UK. 10. School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK. 11. Divisions of Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 12. University Medical Center Freiburg, Freiburg, Germany. 13. Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia. 14. Manchester University NHS Foundation Trust, Manchester, UK. 15. The Alan Turing Institute, London, UK. 16. Department of Psychiatry, University of Oxford, Oxford, UK.
Abstract
BACKGROUND: It is important to evaluate sequalae for complex chronic health conditions such as endometriosis and mental health disorders. Endometriosis impacts 1 in 10 women. Mental health outcomes can be a primary determinant in many physical health conditions although this is an area not well researched particularly in women's health. This has been problematic for endometriosis patients in particular, who report mental health issues as well as other key comorbidities such as chronic pelvic pain and infertility. This could be partly due to the complexities associated with comprehensively exploring overlaps between physical and mental health disorders in the presence of multiple comorbidities and their potential mechanistic relationship. METHODS: In this evidence synthesis, a systematic methodology and mixed-methods approaches were used to synthesize both qualitative and quantitative data to examine the prevalence of the overlapping sequalae between endometriosis and psychiatric symptoms and disorders. As part of this, an evidence synthesis protocol was developed which included a systematic review protocol that was published on PROSPERO (CRD42020181495). The aim was to identify and evaluate mental health reported outcomes and prevalence of symptoms and psychiatric disorders associated with endometriosis. FINDINGS: A total of 34 papers were included in the systematic review and 15 were included in the meta-analysis. Anxiety and depression symptoms were the most commonly reported mental health outcomes while a pooled analysis also revealed high prevalence of chronic pelvic pain and dyspareunia. INTERPRETATION: It is evident that small-scale cross-sectional studies have been conducted in a variety of settings to determine mental health outcomes among endometriosis patients. Further research is required to comprehensively evaluate the mental health sequalae with endometriosis.
BACKGROUND: It is important to evaluate sequalae for complex chronic health conditions such as endometriosis and mental health disorders. Endometriosis impacts 1 in 10 women. Mental health outcomes can be a primary determinant in many physical health conditions although this is an area not well researched particularly in women's health. This has been problematic for endometriosispatients in particular, who report mental health issues as well as other key comorbidities such as chronic pelvic pain and infertility. This could be partly due to the complexities associated with comprehensively exploring overlaps between physical and mental health disorders in the presence of multiple comorbidities and their potential mechanistic relationship. METHODS: In this evidence synthesis, a systematic methodology and mixed-methods approaches were used to synthesize both qualitative and quantitative data to examine the prevalence of the overlapping sequalae between endometriosis and psychiatric symptoms and disorders. As part of this, an evidence synthesis protocol was developed which included a systematic review protocol that was published on PROSPERO (CRD42020181495). The aim was to identify and evaluate mental health reported outcomes and prevalence of symptoms and psychiatric disorders associated with endometriosis. FINDINGS: A total of 34 papers were included in the systematic review and 15 were included in the meta-analysis. Anxiety and depression symptoms were the most commonly reported mental health outcomes while a pooled analysis also revealed high prevalence of chronic pelvic pain and dyspareunia. INTERPRETATION: It is evident that small-scale cross-sectional studies have been conducted in a variety of settings to determine mental health outcomes among endometriosispatients. Further research is required to comprehensively evaluate the mental health sequalae with endometriosis.