Psychological hallmarks of endometriosis with emphasis on sexual dysfunction, stress, anxiety and depression
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Abstract
Introduction More than 50% of women with endometriosis report that they suffer from sexual dysfunctions, the most significant of which is pain, which can subsequently be associated with stress, anxiety, depression. The aim of this study was to evaluate the relationship between sexual function, stress, anxiety and depression together with the values of stress hormones such as cortisol and prolactin in women with endometriosis. Objectives Endometriosis can occur in up to 15% of women. A characteristic feature is the presence of tissue resembling the endometrium outside the uterine cavity. Endometriosis is an estrogen-dependent disease that is associated with fertility disorders (incidence up to 40%) and sexual dysfunction (up to 50% of patients). Endocrine and immune changes may be associated with chronic stress, anxiety and even depression. Methods A total of 92 patients with endometriosis were included in the study. Clinical examinations were focused on biochemical analysis of cortisol and prolactin. At the same time, sexual function, symptoms of stress, anxiety and depression were psychometrically evaluated in these patients. Results In the mutual statistical assessment, positive correlations were found between the results of the Beck scale questionnaire for assessing the severity of depression (BDI-II) and PRL (R = 0.39), then confirmed by Mann-Whitney test (z-score is 5.98019, p value is <0.00001, result is significant at p <0.05). Furthermore, the correlation between BDI-II and HAM-A (R = 0.33), confirmed by the Mann-Whitney test (z-score is -8.55827, p value is <0.00001, the result is significant at p <0.05) (Fig.). Positive correlations were found between TSC-40 and FSDS-R (R = 0.30), confirmed by Mann-Whitney test (z-score is 3.89503, the value of p is 0., 0001, the result is significant at p <0.05). We also found a high correlation between PRL and HAM-A (R = 0.86). Cortisol levels did not show any positive correlation. Conclusions Sexual dysfunction usually accompanies up to 50% of patients with endometriosis. This in turn affects the mental health and well-being of not only the patients, but also their sexual partners. The results of this study are consistent with the hypothesis of possible relationships between stress, anxiety, depression and neuroendocrine markers in patients with endometriosis. Women diagnosed with the symptoms of endometriosis should also be examined for psychosocial and psychiatric disorders at the same time. In this regard, it is important not to underestimate the psychological assessment of those patients who are at risk of developing symptoms of anxiety and depression and to provide them with appropriate psychological support. Disclosure of Interest None Declared
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Conclusions
By leading reliable sexual education one may affect
better attitude to bodies among young adults, who are in a sensitive
phase for building stable relationships with other people. Simul-
taneously one may improve their mental, physical and social well-
being.
Disclosure of Interest: None Declared
EPP1071
Characterization of a population of transgender
individuals and their perceived negative mental health
and life experiences
M. F. Santos *, J. Mota and Z. Figueiredo
Department of Psychiatry, Hospital de Magalhães Lemos, Porto,
Portugal
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.1344
Introduction
Gender dysphoria (GD) is characterized by a
marked incongruence between one’s experienced/expressed gender
and gender assigned at birth, associated with clinically significant
distress or impairment in important areas of functioning. Persons
with GD are a population with specific healthcare needs. In our
hospital, psychiatric assessment of these individuals started in 2008.
Objectives
Characterization of a population of transgender individ-
uals and their perceived negative mental health and life experiences.
Methods
Since the beginning of evaluations of transgender indi-
viduals in our hospital, from 2008 to 2022, they were asked to freely
elaborate their “life story”: a report of the most relevant events in
their lives, related to their condition. We retrospectively analyzed
the content of the reports that were sent and associated with the
clinical files.
Results
We collected the data of 104 individuals. The gender
attributed at birth consisted of 74 (71.2%) females and 30 (28.8%)
males. As for the gender identity, the sample consisted of 73 (70.2%)
males, 28 (26.9%) females, 2 (1.9%) nonbinary and 1 (1%) person
didn’t identify with any of the existent denominations. The medium
age in October of 2022 was 27.4 (minimum 18, maximum 60, SD
7.3). The age at first evaluation at consult was 23.6 (minimum
15, maximum 56, SD 7.2). 99 (95.2%) individuals mentioned symp-
toms of gender non-conformity beginning in childhood, and of
those who mentioned their adolescence (n =43, 41.3%), all
expressed feelings of anguish relating to their changing bodies.
The medium age of recognition of their condition was 17.2 (min-
imum 11, maximum 30, SD 4.3). Of those who recall their first
contact with health practitioners regarding their symptoms (n =31,
29.8%), 32.3% admitted they didn ’t feel they were helped. Of those
who mentioned early relationships with family and carers (n =65,
62,5%), 35.4% reveal dysfunctional relationships and 79% mention
gender expectations from their families. Similarly, 42 (40.4%)
individuals reveal experiences of victimization and bullying because
of their gender nonconformity. 53 (60.2%) described symptoms of a
likely comorbid psychiatric illness throughout their life, particu-
larly depressive symptoms, anxious symptoms, suicide attempts
and non-suicidal self-injury.
Conclusions
GD has gained more attention in the recent years,
and the scientific community has now developed a more accurate
set of criteria for the recognition of this condition. The findings in
our study are in accordance with these criteria. Unfortunately,
much of the suffering this condition entails is also associated with
distress related to stigma and societal gender expectations, and that
was evident in this investigation.
Disclosure of Interest: None Declared
EPP1072
Psychological hallmarks of endometriosis with
emphasis on sexual dysfunction, stress, anxiety and
depression
R. Sajdlova* and L. Fiala
Sexology department, Faculty of medicine in Pilsen, Charles
University, Pilsen, Czech Republic
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.1345
Introduction
More than 50% of women with endometriosis report
that they suffer from sexual dysfunctions, the most significant of
which is pain, which can subsequently be associated with stress,
anxiety, depression. The aim of this study was to evaluate the
relationship between sexual function, stress, anxiety and depression
together with the values of stress hormones such as cortisol and
prolactin in women with endometriosis.
Objectives
Endometriosis can occur in up to 15% of women.
A characteristic feature is the presence of tissue resembling the
endometrium outside the uterine cavity. Endometriosis is an
estrogen-dependent disease that is associated with fertility dis-
orders (incidence up to 40%) and sexual dysfunction (up to 50%
of patients). Endocrine and immune changes may be associated
with chronic stress, anxiety and even depression.
Methods
A total of 92 patients with endometriosis were included
in the study. Clinical examinations were focused on biochemical
analysis of cortisol and prolactin. At the same time, sexual function,
symptoms of stress, anxiety and depression were psychometrically
evaluated in these patients.
Results
In the mutual statistical assessment, positive correlations
were found between the results of the Beck scale questionnaire for
assessing the severity of depression (BDI-II) and PRL (R = 0.39),
then confirmed by Mann-Whitney test (z-score is 5.98019, p value
is <0.00001, result is significant at p <0.05). Furthermore, the
correlation between BDI-II and HAM-A (R = 0.33), confirmed
by the Mann-Whitney test (z-score is -8.55827, p value is <0.00001,
the result is significant at p <0.05) (Fig.). Positive correlations were
found between TSC-40 and FSDS-R (R = 0.30), confirmed by
Mann-Whitney test (z-score is 3.89503, the value of p is 0., 0001,
the result is significant at p <0.05). We also found a high correlation
between PRL and HAM-A (R = 0.86). Cortisol levels did not show
any positive correlation.
S646 e-Poster Presentation
https://doi.org/10.1192/j.eurpsy.2023.1345 Published online by Cambridge University Press
Conclusions
Sexual dysfunction usually accompanies up to 50% of
patients with endometriosis. This in turn affects the mental health
and well-being of not only the patients, but also their sexual
partners. The results of this study are consistent with the hypothesis
of possible relationships between stress, anxiety, depression and
neuroendocrine markers in patients with endometriosis.
Women diagnosed with the symptoms of endometriosis should
also be examined for psychosocial and psychiatric disorders at the
same time. In this regard, it is important not to underestimate the
psychological assessment of those patients who are at risk of
developing symptoms of anxiety and depression and to provide
them with appropriate psychological support.
Disclosure of Interest: None Declared
EPP1074
Efficacy of Treatments for Anorgasmia in
Premenopausal Women According to Evidence-Based
Practice: A Systematic Review
T. J. Gould * and S. M. Edney
Cardiff University School of Medicine, Cardiff University, Cardiff,
United Kingdom
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.1346
Introduction
This review determined the effectiveness of female
anorgasmia treatments in premenopausal women using a system-
atic search strategy. This review considers all physiological,
pharmaceutical, psychological and social treatments. Thomas and
Thurston (Maturitas 2016; 87 49-60) recommend a biopsychosocial
approach, where subjective distress and physical factors can coexist
(Brotto et al. JSM 2010; 586-614). Yet, methodological issues are
rife e.g., obtaining representative samples and limited assessment
methods. Further, reviews are narrative with limited synthesis
(Marchand SMR 2021; 9(2) 194-211). Frühauf et al. (Archives of
Sexual Behavior 2013; 42(6) 915-933) completed a review, but there
is no account for research published after 2007 and limited follow-
up assessments.
Objectives
This is the first systematic review of premenopausal
anorgasmia with assessment of bias for all treatments. This review is
restricted to anorgasmia to better isolate interventions and exclude
comorbid conditions.
Methods
10 different databases were searched (2007-2021) includ-
ing studies from peer-reviewed journal articles and grey literature.
Results
were synthesised in forest plots according to timepoints of
data, alongside different treatments to determine effect size from
standardised mean differences (SMD). Outcome measures
included the self-reported sexual function, sexual distress and
clinician observation. The SMD was used as not all scales are
consistent across studies. All results given are in line with a pre-
defined analysis plan.
Results
Of 1388 studies screened, 15 studies (2002-2020) were
analysed: study designs were mixed with mostly self-report meas-
ures. Effective treatments included Tribulus terrestris (M =3.77,
p<0.01), plasma injection (M=4.48, p<0.01), and CO2 laser therapy
(M=4.06, p<0.05). For psychological studies, assessment of active
sexual engagement described how subjects felt more aware of their
sexuality which improved outcomes. Limitations of most studies
included a very high risk of bias, notably in randomisation of
subjects, allocation and outcomes. All interventions had a signifi-
cant effect in independent t-tests, yet synthesis of SMDs show
insignificant effect, implying data is inconclusive.
Conclusions
This review aimed to systematically appraise all
treatments for orgasmic satisfaction for premenopausal women.
Higher levels of significance were observed for treatments across all
modalities. The efficacy of natural supplements has been disputed
(IsHak et al. JSM 2010; 7(10) 3254-3268), but this review shows
promise. All psychological results provided insight into the role of
the therapist-client relationship and reappraisal of traumatic sexual
experience. Yet, risk of bias is likely impacted by difficulty estab-
lishing standardised scientific protocol. Considerations for future
research include clear statements of randomisation and multi-
faceted outcome measures.
Disclosure of Interest: None Declared
Women, Gender and Mental Health 02
EPP1075
Gender Differences In The Therapeutic Evolution Of
Major Depression during COVID-19 Pandemic
C. Navarro-Guzmán1, A. Aguilar-Latorre 2*, A. García 1,
M. Zamrik Vila 1, A. M. Yáñez 1, M. Gili-Planas 1 and
M. Garcia-Toro1
1University of the Balearic Islands, Palma and 2Institute for Health
Research Aragón (IIS Aragón), Zaragoza, Spain
*Corresponding author.
doi: 10.1192/j.eurpsy.2023.1347
Introduction
The COVID-19 pandemic has posed an enormous
challenge to the mental health of the population with probable
differentiated profiles for men and women, although not all studies
are consistent. While women are likely to have endured greater
loads of stress associated with an increased incidence of mental
disorders such as depression, men have been able to abuse alcohol
and other drugs more, in addition to complying with prevention
recommendations to a lesser extent. As soon as the COVID pan-
demic began, we began a clinical trial to enhance first-line treat-
ments with three complementary interventions with patients with
Major Depression (MD), which has allowed us to analyze differ-
ences in response according to gender.
Objectives
As a secondary analysis of a clinical trial, the aim of
the current study was to address the relative different efficacy
between genders of three psychotherapeutic approaches in the
context of MD.
Methods
This study was a secondary analysis of a pragmatic
parallel randomized controlled clinical trial that was composed of
three arms (Minimal Lifestyle Intervention, Mindfulness-Based
Cognitive Therapy, and Lifestyle Modification Program). We
recruited 94 individuals (24 men and 70 women) from the Primary
Healthcare Centers of the Balearic Islands region in Spain who were
currently experiencing an episode of MD. Descriptive and univari-
ate analyses were used to examine between-group differences in
European Psychiatry S647
https://doi.org/10.1192/j.eurpsy.2023.1345 Published online by Cambridge University Press
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