子宫内膜异位症的心身共病：一项多中心、横断面研究，确定了当前医疗支持中被低估的因素

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-08-09 DOI:10.1016/j.jpsychores.2025.112346

Aylin Candan , Alexandra Kohl Schwartz , Kurt Birchler , Brigitte Leeners

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引用次数: 0

摘要

目的子宫内膜异位症影响约10%的女性，并与慢性盆腔疼痛、疲劳、不孕和生活质量下降有关。本研究探讨心身疾病/症状与子宫内膜异位症之间的关系。方法在瑞士、德国和奥地利对422名子宫内膜异位症患者和422名年龄匹配的对照组进行了一项多中心研究。数据是通过自我管理的问卷收集的，包括社会人口统计信息、健康史（包括心身疾病）和子宫内膜异位症症状。子宫内膜异位症的信息是从患者的病历中提取的。ClinicalTrials.gov NCT 02511626。结果心身疾病/症状与子宫内膜异位症的诊断相关，而生理疾病与子宫内膜异位症的诊断无关。子宫内膜异位症女性报告的疼痛障碍（偏头痛/头痛（非常）常为25.12% / 12.33%，背痛32.46% / 16.83%，胸痛14.93% / 4.26%，胃痛19.67% / 7.11%，p值均为<；0.001），心理健康障碍（易怒22.98% / 10.50%，情绪波动34.59% / 9.48%，抑郁情绪17.33% / 2.81%，焦虑感8.29% / 1.42%，p值均为<；0.001），睡眠障碍（33.18% / 11.84%，p值均为<；0.001）；0.001)，颈部张力(50.94% / 34.60%,p <；0.001)，磨牙(18.72% / 9.24% p <；0.04)，食欲减退(6.16% / 2.37%,p <；0.02),消化问题(31.99% / 11.13%,p & lt;0.001)，腹泻(15.17% / 4.50%,p <；0.001)，哮喘(3.55% / 0.71%,p <；0.001)，呼吸困难(6.16% / 1.19%,p <；0.10)，比对照组女性高。伴有心身合并症的女性发生子宫内膜异位症相关疼痛的频率（≥数次/天30.47% / 10.58%,p = 0.013）更高。结论本研究支持心身合并症与子宫内膜异位症之间的密切联系。这种关联的病理生理机制应进一步评估，以更好地了解子宫内膜异位症的发展。子宫内膜异位症的治疗应采用综合、多学科的方法，结合生理和心理方面，以提高患者的预后和生活质量。

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Psychosomatic comorbidity in endometriosis: A multi-center, cross-sectional study identifying an underestimated factor in current medical support

Objective

Endometriosis affects approximately 10 % of women and is associated with chronic pelvic pain, fatigue, infertility, and impaired quality of life. This study explores the association between psychosomatic diseases/ symptoms and endometriosis.

Methods

A multi-center study involving 422 women with endometriosis and 422 age-matched control women was conducted in Switzerland, Germany, and Austria. Data was collected using a self-administered questionnaire covering socio-demographic information, health history including psychosomatic diseases, and endometriosis symptoms. Information on endometriosis was extracted from the patients' medical charts. ClinicalTrials.gov NCT 02511626.

Results

Psychosomatic diseases/ symptoms but not physiological diseases were associated with a diagnosis of endometriosis. Women with endometriosis reported significantly higher frequencies of pain disorders (migraine/headache (very) often 25.12 %/12.33 %, back pain 32.46 %/16.83 %, chest pain 14.93 %/4.26 %, stomach pain 19.67 %/7.11 %, all p-values <0.001), disturbed mental health (irritability 22.98 %/10.50 %, mood swings 34.59 %/9.48 %, depressive mood 17.33 %/2.81 %, feelings of anxiety 8.29 %/1.42 %, all p-values <0.001), sleeping disorders (33.18 %/11.84 %, p < 0.001), neck tension (50.94 %/34.60 %, p < 0.001), teeth grinding (18.72 %/9.24 % p < 0.04), appetite loss (6.16 %/2.37 %, p < 0.02), digestive problems (31.99 %/11.13 %, p < 0.001), diarrhea (15.17 %/4.50 %, p < 0.001), asthma (3.55 %/0.71 %, p < 0.001), and breathing difficulties (6.16 %/1.19 %, p < 0.10) than did control women. The frequency (≥several times/day 30.47 %/10.58 %, p = 0.013) of endometriosis-related pain was greater in women with psychosomatic comorbidity.

Conclusions

The study supports a strong association between psychosomatic comorbidity and endometriosis. Pathophysiological mechanisms of this association should be further evaluated to better understand endometriosis development. Endometriosis should be treated with a holistic, multidisciplinary approach, combining physical and psychological aspects to enhance patient outcomes and quality of life.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.