Central sensitization and mental health outcomes of endometriosis patients during the COVID-19 pandemic

Central sensitization and mental health outcomes of endometriosis patients during the COVID-19 pandemic

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2023 · PMC10211482

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This study linked endometriosis patient data with mental health outcomes during the COVID-19 pandemic, finding that central sensitization was associated with worse depression and anxiety scores.

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This study investigated the association between central nervous system sensitization and mental health outcomes in patients with endometriosis during the COVID-19 pandemic. Researchers linked data from two British Columbia cohorts, analyzing baseline Central Sensitization Inventory scores and comorbidities against subsequent depression and anxiety levels measured via PHQ-9 and GAD-7 scales. The multivariable analysis revealed that higher baseline central sensitization scores and a greater number of central sensitivity syndrome comorbidities were significantly associated with worse mental health outcomes, even after controlling for age, BMI, parity, and baseline mental health status. This paper is centrally about endometriosis — specifically examining how central sensitization impacts mental health in this patient population during periods of external stress.

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Methods

Data were linked between two British Columbia databases: the prospective Endometriosis Pelvic Pain Interdisciplinary cohort (EPPIC) that phenotypes endometriosis patients; and the Rapid Evidence Study of a Provincial Population Based Cohort for Gender and Sex cohort (RESPPONSE) that follows mental health outcomes during the COVID-19 pandemic. The predictors were the Central Sensitization Inventory (CSI) score and central sensitivity syndrome (CSS) comorbidities at baseline from EPPIC. The primary outcomes were PHQ-9 (depression) and GAD-7 (anxiety) scores in Phase 1 of the pandemic from RESPPONSE. Bivariate and multivariable analyses were performed.

Results

There were N=329 subjects in the linked dataset. On bivariate analysis, more central sensitization at baseline (i.e. higher CSI scores and more CSS comorbidities) was strongly associated with worse mental health during the pandemic (i.e. higher PHQ-9 and GAD-7 scores). On multivariable regression, after controlling for baseline mental health measures, age, BMI, and parity, both the CSI score and the number of CSS comorbidities at baseline were associated with worse PHQ-9 ( P <0.0001, P = 0.0075) and worse GAD-7 ( P <0.0001, P = 0.0054) scores during the pandemic.

Objectives

To determine whether central nervous system sensitization in patients with endometriosis was associated with worse mental health outcomes during the COVID-19 pandemic.

Conclusions

Central nervous system sensitization was associated with worse mental health for endometriosis patients during the COVID-19 pandemic. Central sensitization may predict mental health outcomes in the face of a pandemic or other stressors.

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endometriosis

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