Does Pain Acceptance mediate the Relationship between Chronic Pelvic Pain and Depressive Symptoms in Females with Endometriosis?

Background. Endometriosis is a debilitating gynecological disorder, oftentimes accompanied by chronic pelvic pain (CPP) and mental health conditions such as depression. Previous research has established that CPP, which is unrelated to the occurrence of menstruation, is highly predictive of depression scores in females with endometriosis. In the context of patients with chronic illnesses, pain acceptance has been highlighted as playing a crucial role in psychological outcomes such as depression. Pain acceptance is determined by the extent to which a life-focus, or a pain-focus is maintained. The main objective of the study was to determine the interplay between CPP, pain acceptance and depression in participants diagnosed with endometriosis. Methods. The study had a retrospective, cross-sectional research design, using convenience sampling to recruit respondents. A final 232 respondents completed the survey, composed of an ad-hoc item to measure CPP (Numeric Rating Scale, NRS) and...Show moreBackground. Endometriosis is a debilitating gynecological disorder, oftentimes accompanied by chronic pelvic pain (CPP) and mental health conditions such as depression. Previous research has established that CPP, which is unrelated to the occurrence of menstruation, is highly predictive of depression scores in females with endometriosis. In the context of patients with chronic illnesses, pain acceptance has been highlighted as playing a crucial role in psychological outcomes such as depression. Pain acceptance is determined by the extent to which a life-focus, or a pain-focus is maintained. The main objective of the study was to determine the interplay between CPP, pain acceptance and depression in participants diagnosed with endometriosis. Methods. The study had a retrospective, cross-sectional research design, using convenience sampling to recruit respondents. A final 232 respondents completed the survey, composed of an ad-hoc item to measure CPP (Numeric Rating Scale, NRS) and validated questionnaires to examine pain acceptance (Chronic Pain Acceptance Questionnaire – 8, CPAQ-8) and depression (Patient Health Questionnaire – 9, PHQ-9). A correlation between CPP and depression was conducted, and the mediatory effect of pain acceptance in this relationship was investigated. Results. Initially, a significant and positive, however weak correlation between CPP and depression was found. Subsequently, pain acceptance was determined as a significant mediator in the relationship between CPP and depression. Discussion. In comparison with previous research in the general population, the PHQ-9 scores were higher and CPAQ-8 scores were lower in this study, indicating more severe depression, and lower pain acceptance scores. The mediation model established that experiencing CPP negatively impacts pain acceptance, which negatively impacts depression in females with endometriosis. Further research on mental health vulnerabilities in females with endometriosis, and an increase in social awareness and professional support is required.Show less

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Does Pain Acceptance mediate the Relationship between Chronic Pelvic Pain and Depressive Symptoms in Females with Endometriosis?