Determinants of mental health outcomes in individuals with endometriosis in Croatia

The primary aim of this study is to examine the relationships between pain, fatigue, catastrophizing and mental health outcomes in individuals with endometriosis. Specifically, the study seeks to identify the extent to which catastrophizing, pain and fatigue contribute to depression, anxiety and stress, and to explore the potential moderating role of catastrophizing and symptom type in the relationship between pain and mental health outcomes. Drawing on existing literature and clinical findings, the study is grounded in the hypothesis that greater levels of pain, fatigue, and catastrophizing are associated with mental health impairment. It is expected that these variables will significantly predict higher levels of depression, anxiety and stress. Furthermore, it is hypothesized that higher catastrophizing and experiencing more than one symptom type will amplify the impact of pain on mental health outcomes, acting as moderating variables. Participants will consist of 150 adult women residing in Croatia, all of whom have received a medical diagnosis of endometriosis. Recruitment will be conducted online through endometriosis-related social media groups. Individuals currently pregnant, postmenopausal or diagnosed with a comorbid psychiatric disorder will be excluded from participation. Data will be collected through an online survey comprising validated self-report instruments. Mental health outcomes will be evaluated using the Depression, Anxiety and Stress Scale (DASS-21), while catastrophizing will be measured using the Catastrophizing subscale from the Coping Strategies Questionnaire (CSQ). Pain intensity and fatigue will be assessed using Visual Analogue Scales (VAS), with additional single-item measures for pain and fatigue duration. Symptom type will be measured using a check-list listing the most common endometriosis symptoms.