Psychosocial factors associated with pain and health‐related quality of life in Endometriosis: A systematic review
Open accessAbstract
Background and Objective: Endometriosis is associated with pain and impaired health‐related quality of life (HRQoL). Psychosocial factors have been associated with pain and HRQoL in other conditions, suggesting their potential relevance in Endometriosis. However, the role of psychosocial factors in this population has not been systematically explored yet. This systematic review aims to explore the association of psychosocial factors with pain intensity/severity and HRQoL in women with Endometriosis. Databases and Data Treatment: Observational and experimental studies that explored the association of psychosocial factors with pain and HRQoL in women with Endometriosis were eligible. The following databases were searched: Medline, Embase, Cochrane library, Web of Science, PsychInfo and Cumulative index of nursing and allied health literature. The methodological quality was assessed, and findings were synthesized using narrative synthesis. Results: Twenty‐seven studies were eligible for inclusion, which included 5419 women with Endometriosis. Catastrophising and anxiety were the factors most consistently associated with greater pain, whilst depression, anxiety and stress were related to worse HRQoL. Findings regarding depression and pain were mixed, and research on social factors was limited. Conclusions: This systematic review highlights the role of psychosocial factors in Endometriosis. Anxiety, depression and catastrophising are suggested as potential treatment targets. The review also indicates the lack of research on other potentially important psychosocial factors, such as avoidance, perceived injustice and social support. Significance: This systematic review explored the role of psychosocial factors in Endometriosis, suggesting that these are associated with pain and health‐related quality of life (HRQoL). Among the psychosocial factors included, anxiety, depression and catastrophising were the factors most often associated with pain and HRQoL in Endometriosis. These findings highlight the need to target psychological factors in the treatment of women with Endometriosis.
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One major potential source of pain exacerbation is thinking the worst.
“One major potential source of pain exacerbation is thinking the worst [21].”
From Endometriosis: patient–doctor communication and psychological counselling (2023) · cites this paper as [21]
The Discussion links catastrophising—thinking the worst about pain—with greater pain and says catastrophic interpretations could increase pain through fear and avoidance. But the Main Results describe the observed associations as small, so the source does not establish it as a major source of pain exacerbation. (LLM, conf=0.84)
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References 96 · Cited by 95
- Authors
- Kalfas, M., Chisari, C., & Windgassen, S.
- Affiliations
- King's College London (GB)
- Health Psychology Section Institute of Psychiatry, Psychology, and Neuroscience, King's College London London UK
- Corresponding author
- Windgassen, Sula
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2022-07-22
- Volume
- 26
- Issue
- 9
- Pages
- 1827-1848
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- PMC
- PMC9543695
- OpenAlex
- W4284963620
- Cited by
- 95
- References
- 96
- Citations by year
- 2026: 27 · 2025: 27 · 2024: 22 · 2023: 18 · 2022: 1
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Pain (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- King's College London
- South London and Maudsley NHS Foundation Trust
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- endometriosis, psychosocial factors, pain intensity, health-related quality of life, pain catastrophizing, anxiety, depression, stress, social support, perceived injustice
- MeSH terms
- Anxiety, Anxiety Disorders, Depression, Endometriosis, Female, Humans, Pain, Quality of Life
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