The gynecologic oncology consult: symptom presentation and concurrent symptoms of depression and anxiety.

Fowler JM, Carpenter KM, Gupta P, Golden-Kreutz DM, Barbara L. Andersen
Obstetrics and gynecology · 2004 · doi:10.1097/01.aog.0000127983.70739.d8 · PMID:15172854 · PMC2746486
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This study evaluated the relationship between gynecologic symptoms and emotional distress in 151 women referred to a gynecologic oncology consultation. Participants completed assessments for depression and anxiety, with follow-up diagnoses revealing that half had cancer and half had benign conditions. The results showed no significant difference in symptom reports or distress levels between the cancer and benign groups, though higher numbers of gynecologic symptoms correlated with increased depressive and anxiety symptoms across all patients. Sociodemographic factors such as older age, lack of a partner, and unemployment were also associated with greater emotional vulnerability, while longer partner relationships offered some protective effect. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

ObjectiveTo detail the relationship of gynecologic symptoms and sociodemographic variables to depression and anxiety reports among women who were referred to gynecologic oncologists for evaluation.MethodsConsecutive patients (N = 151) from an National Cancer Institute-designated comprehensive cancer center were accrued and participated on the day of consultation. Patients completed measures assessing depression (Center for Epidemiological Studies Depression Scale) and anxiety (Beck Anxiety Inventory) symptoms, common gynecologic signs/symptoms, and sociodemographic characteristics. Patients were followed up and subsequent diagnoses yielded 73 (48%) cancer and 78 (52%) benign cases.ResultsDescriptive analyses revealed that the cancer group was significantly older (52 versus 45 years) than the benign group, and variables correlated with age also differed significantly, with the cancer sample more likely to be postmenopausal, unemployed, and if employed, working fewer hours per week. Importantly, the groups did not differ on reports of depressive, anxiety, or gynecologic symptoms. Hierarchical multiple regression analyses, collapsing across groups, yielded significant correlates of emotional distress. Women who were older, without a spouse/partner, and who had more gynecologic symptoms had higher levels of both depressive and anxiety symptoms. Among the women who did have a partner, those with relationships of longer duration reported lower levels of depression/anxietyConclusionReports of clinically significant depressive (42%) and anxiety symptoms (30%) were high. The number of gynecologic symptoms was reliably correlated with emotional distress. Age and absence of partner may have conferred added vulnerability. For those women with partners, lengthier relationships appeared to offer protection from both depressive and anxiety symptoms.Level of evidenceIII
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Objective

To detail the relationship of gynecologic symptoms and sociodemographic variables to depression and anxiety reports among women who were referred to gynecologic oncologists for evaluation.

Methods

Consecutive patients (N = 151) from an National Cancer Institute–designated comprehensive cancer center were accrued and participated on the day of consultation. Patients completed measures assessing depression (Center for Epidemiological Studies Depression Scale) and anxiety (Beck Anxiety Inventory) symptoms, common gynecologic signs/symptoms, and sociodemographic characteristics. Patients were followed up and subsequent diagnoses yielded 73 (48%) cancer and 78 (52%) benign cases.

Results

Descriptive analyses revealed that the cancer group was significantly older (52 versus 45 years) than the benign group, and variables correlated with age also differed significantly, with the cancer sample more likely to be postmenopausal, unemployed, and if employed, working fewer hours per week. Importantly, the groups did not differ on reports of depressive, anxiety, or gynecologic symptoms. Hierarchical multiple regression analyses, collapsing across groups, yielded significant correlates of emotional distress. Women who were older, without a spouse/partner, and who had more gynecologic symptoms had higher levels of both depressive and anxiety symptoms. Among the women who did have a partner, those with relationships of longer duration reported lower levels of depression/anxiety

Conclusion

Reports of clinically significant depressive (42%) and anxiety symptoms (30%) were high. The number of gynecologic symptoms was reliably correlated with emotional distress. Age and absence of partner may have conferred added vulnerability. For those women with partners, lengthier relationships appeared to offer protection from both depressive and anxiety symptoms. LEVEL OF EVIDENCE: III

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