Association between depressive symptoms and dienogest in patients treated for endometriosis: Using the Center for Epidemiological Studies Depression (CES-D) and the State-Trait Anxiety Inventory (STAI)

OBJECTIVE: This study aimed to investigate the effects of dienogest on depressive symptoms and anxiety in patients with endometriosis using the Center for Epidemiologic Studies Depression (CES-D) and State-Trait Anxiety Inventory (STAI). MATERIALS AND METHODS: This prospective observational study included patients diagnosed with endometriosis based on imaging findings or postoperative pathological tests. All participants took 2 mg dienogest (Visanne®) every day for 6 months. They visited the hospital on the first day and six months after taking dienogest and filled out answers to the CES-D and STAI questionnaires. The independent-samples t-test, Pearson's χ2 test, Fisher's exact test, and logistic regression test were performed. RESULTS: Of the 97 patients enrolled in the study, 30 patients who completed all questionnaires were included in the analysis. After 6 months of dienogest treatment in patients with endometriosis, menstrual pain improved from Visual Analogue Scale (VAS) score 5.75 ± 3.4 to 1.40 ± 1.4 (p = 0.002). However, the CES-D score significantly increased from 9.1 ± 3.4 to 13.2 ± 7.5 (p = 0.002). Moreover, 11 of the 30 patients (36.7 %) reached a score indicating clinically significant depressive symptoms. The STAI scores increased after 6 months of taking dienogest without statistical significance. In a regression analysis, the higher the initial CES-D score, the higher the risk of depressive symptoms (adjusted OR 1.54, 95 % CI 1.02-2.32, p = 0.04). CONCLUSION: Dienogest treatment was associated with clinically significant depressive symptoms in over one-third of patients, underscoring the need for mental health screening during therapy.