Assessing Frequency of Anxiety and Depression in Women with Chronic Pelvic Pain

Chronic pelvic pain, like many chronic pain conditions, is associated with depression and anxiety. Women are disproportionately affected collectively and separately by both chronic pain and anxiety disorders, especially generalized anxiety disorder. While anxiety and depression commonly co-occur in chronic pelvic pain patients, anxiety may exist without the presence of depression. Depression is commonly screened for in pain management, whereas anxiety is often not, missing a subset patient population. Screening solely for depression neglects patients with disabling anxiety that may contribute to treatment resistance in chronic pain management. This oversight potentially neglects an entire population of women with chronic pelvic pain who may benefit from referral to mental health services. The purpose of this quality improvement project was to assess the frequency of anxiety and depression, independently and concurrently, in women with chronic pelvic pain. This project design was a cross sectional design utilizing two instruments, the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), in a pelvic physical therapy clinic. Data was collected electronically using REDCap. Patients who screened positive for anxiety and/or depression were referred back to their referring provider for further evaluation. A total of 13 surveys were collected from women with chronic pelvic pain who met inclusion criteria. Seven of the 13 respondents scored as having moderate to severe anxiety, depression, or mixed anxiety/depression. Of those that met the cut score of 10, 57.1% scored as having anxiety without the presence of depression indicating the need for screening for both depression and anxiety instead of screening for depression alone.