Psychosomatic status of women of reproductive age with adenomyosis

М. E. Azizova
In: Reproductive health of woman · 2024 · pp. 41–46 · doi:10.30841/2708-8731.3.2024.305508 · W4399287774
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Women of reproductive age with adenomyosis experience anxiety-phobic, depressive, and affective disorders, alongside sexual and obsessive symptoms.

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This prospective clinical-laboratory and instrumental study assessed the psychosomatic status of 224 women aged 30–50 with adenomyosis, stratified by diffuse (n=106) versus nodular (n=118) forms, using the Aleksandrowicz Neurotic Disorders—Symptomatic (QND-S) questionnaire, and compared them with 84 healthy controls with regular ovulatory cycles and no gynecologic disease history. The authors found menstrual cycle disturbances as hyperpolymenorrhea in nearly one-third and algomenorrhea in nearly half of patients, and reported the most common psychosomatic-pattern features as affective tension, sleep disorders, and anxiety–phobic disorders, with additional prominence of depressive, sexual, obsessive, and anancastic personality-related symptoms. A stated limitation is that the work is based on questionnaire-based psychosomatic assessment alongside clinical data rather than objective psychiatric diagnosis, and it reports only distributional/categorical findings. This paper is centrally about adenomyosis — it studies how adenomyosis is associated with women’s psychosomatic status and neurotic symptom profiles.

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Abstract

The objective: to study the impact of adenomyosis on the psychosomatic status of women of reproductive age.Materials and methods. A complex clinical-laboratory and instrumental prospective examination for women with adenomyosis was conducted in 224 patients aged 30 to 50 years (average age – 42.0±1.8 years). These patients were included in the main group of the study. The patients of the main group were divided into two subgroups depending on the form of adenomyosis: Group I – diffuse form – 106 women, Group II – nodular form – 118 women.The control group included 84 healthy women of reproductive age with a regular ovulatory menstrual cycle and no history of gynecological diseases.To assess the psychosomatic status of patients with adenomyosis we used the Aleksandrowicz method: a questionnaire of neurotic disorders – symptomatic (QND- S).Results. The conducted studies established that the largest number of patients were 36–40 years old – 92 (41.1±3.3%) women in the main group, and 37 (44.0±5.4%) women in the control group. A total of 152 (67.9±3.1%) patients of the main group were of reproductive age, 72 (32.1±3.1%) patients were of perimenopausal age.In patients with adenomyosis disorder of the menstrual cycle in the form of hyperpolymenorrhea was found in almost every third patient, and algomenorrhea – in almost every second person. The diagnosis was established for the first time in 8.49±2.7% of patients in Group I (9 women) and 3.38±1.8% in Group II (4 women).Less than 5 years of the disease was observed in 34.91±4.6% of patients of the Group I (37 women) and in 51.69±4.6% of the Group II (61 women). From 5 to 10 years, the disease was observed in 56.60±4.8% of patients of the Group I (60 women) and in 44.93±4.6% of the Group II (53 women). Affective stress (up to 15.50%), sleep disorders (up to 20.22%), anxiety-phobic disorders (up to 11.18%) were determined most often.Conclusions. In the vast majority of patients of reproductive age who have adenomyosis with pain syndrome, the personal characteristics are dominated by symptoms such as anxiety-phobic and depressive disorders, affective tension, sexual, obsessive and anankastic disorders.
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Психосоматичний стан жінок репродуктивного віку з аденоміозом Основний зміст сторінки статті Анотація Мета дослідження: вивчення впливу аденоміозу на психосоматичний стан жінок репродуктивного віку. Матеріали та методи. Проведено комплексне клініко-лабораторне та інструментальне проспективне обстеження на аденоміоз 224 хворих віком від 30 до 50 років (середній вік – 42,0±1,8 року). Ці пацієнтки увійшли до основної групи дослідження. Пацієнтки основної групи були розподілені на дві підгрупи залежно від форми аденоміозу: І група – дифузна форма – 106 жінок, ІІ група – вузлова форма – 118 жінок. До контрольної групи включено 84 здорові жінки репродуктивного віку з регулярним овуляторним менструальним циклом і без гінекологічних захворювань в анамнезі. Для оцінювання психосоматичного статусу хворих на аденоміоз використовували метод Aleksandrowicz: опитувальник невротичних розладів – симптоматичний (QND-S). Результати. Проведеними дослідженнями встановлено, що найбільше число становлять пацієнтки віком 36–40 років – 92 (41,1±3,3%) жінки в основній групі, а у контрольній групі – 37 (44,0±5,4%) жінок. Усього 152 (67,9±3,1%) пацієнтки основної групи були репродуктивного віку, 72 (32,1±3,1%) пацієнтки – перименопаузального віку. У хворих на аденоміоз порушення менструального циклу у формі гіперполіменореї виявляли майже у кожної третьої хворої, а альгоменорею – майже у кожної другої. Діагноз уперше встановлено у 8,49±2,7% пацієнток І групи (9 жінок) та 3,38±1,8% – у ІІ групі (4 жінки). Менше 5 років захворювання спостерігалося у 34,91±4,6% хворих І групи (37 жінок) та у 51,69±4,6% – ІІ групи (61 жінка). Від 5 до 10 років захворювання спостерігалося у 56,60±4,8% хворих І групи (60 жінок) та у 44,93±4,6% – ІІ групи (53 жінки). Найбільш часто виявляли афективне напруження (до 15,50%), розлади сну (до 20,22 %), тривожно-фобічні розлади (до 11,18 %). Висновки. У переважної більшості пацієнток репродуктивного віку, які мають аденоміоз з больовим синдромом, в особистісних характеристиках переважають такі симптоми, як тривожно-фобічні та депресивні розлади, афективне напруження, сексуальні, обсесивні та ананкастичні розлади. Блок інформації про статтю Ця робота ліцензується відповідно до Creative Commons Attribution 4.0 International License. Автори зберігають авторське право, а також надають журналу право першого опублікування оригінальних наукових статей на умовах ліцензії Creative Commons Attribution 4.0 International License, що дозволяє іншим розповсюджувати роботу з визнанням авторства твору та першої публікації в цьому журналі. Посилання Aarestrup J, Jensen BW, Ulrich LG, Hartwell D, Trabert B, Baker JL. Birth weight, childhood body mass index and height and risks of endometriosis and adenomyosis. Ann Hum Biol. 2020;47(2):173-80. doi: 10.1080/03014460.2020.1727011. Abrão MS, Andres MP, Barbosa RN, Bassi MA, Kho RM. 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