Depression and anxiety in patients with endometriosis-associated chronic pain: Neuroimmune mechanisms mediated by inflammatory factors

Fan-Chun Yang, Fei Yang, Yang Zhou, Shi-Yun Zhang, Shiyun Zhang, Rui Ma
World journal of psychiatry · 2025 · vol. 15(10) , pp. 107147 · doi:10.5498/wjp.v15.i10.107147 · PMID:41112598 · W4415356593
article OA: diamond CC0
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

This study found that higher levels of inflammatory biomarkers and pain severity correlate with depression and anxiety in women with endometriosis-associated chronic pain, suggesting a neuroimmune mechanism.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

BACKGROUND Endometriosis affects approximately 10% of reproductive-age women and is frequently associated with chronic pelvic pain. Patients with endometriosis often experience comorbid depression and anxiety, but the underlying mechanisms connecting these conditions are unclear. AIM To assess the prevalence of depression and anxiety in endometriosis patients and explore neuroimmune mechanisms mediated via inflammatory biomarkers. METHODS A retrospective cohort study was conducted with 200 patients with endometriosis-associated chronic pain from June 2020 to December 2024. Depression and anxiety were assessed using validated psychological instruments. Inflammation biomarkers interleukin (ILs) (IL-6, IL-1β), tumor necrosis factor-alpha, C-reactive protein, and brain-derived neurotrophic factor were measured in serum. Pain severity was assessed using visual analog scales. Correlation and regression analyses were performed to examine relationships between inflammatory markers, pain severity, and psychological outcomes. RESULTS Among the 200 patients, 42.5% exhibited clinically significant depression and 51.0% showed anxiety symptoms. Serum levels of IL-6, IL-1β, tumor necrosis factor-alpha, and C-reactive protein were significantly higher in patients with comorbid depression and anxiety compared with those without psychological symptoms (P < 0.001). Brain-derived neurotrophic factor levels were lower in the depression group. Pain severity positively correlated with inflammatory marker levels and with depression and anxiety scores. CONCLUSION Overall, the findings suggest that inflammatory factors mediate a neuroimmune mechanism linking endometriosis-associated chronic pain with depression and anxiety. Therapeutic targets for managing psychological comorbidities in patients with endometriosis through anti-inflammatory interventions should be explored, and an integrated treatment approach addressing both physical and psychological symptoms is emphasized.

My notes (saved in your browser only)

Outcome instruments

EHP-30 VAS-pain rASRM

Condition tags

endometriosischronic_pelvic_pain

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (25)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pmc
last seen: 2026-05-13T20:22:03.195721+00:00
pubmed
last seen: 2026-05-30T00:30:57.342446+00:00
License: CC0 · commercial use OK