Current Status of Depression in Patients with Endometriosis and Rheumatoid Arthritis

Abstract

Background: Endometriosis often causes chronic pain and fertility issues, exacerbating the risk of depression and complicating conditions like rheumatoid arthritis, which further impacts quality of life. This study aimed to explore the detection rate of depression in patients with endometriosis and rheumatoid arthritis by using different diagnostic criteria, and to analyze the occurrence and influencing factors. 

Method: A total of 108 patients with endometriosis combined with rheumatoid arthritis in the First Hospital of Lanzhou University from July 2021 to July 2023 were selected as samples. The internationally accepted Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), the new depression assessment tool Hamilton Depression Scale (HAMD), and the Self-rating Depression Scale (SDS) were used to detect the incidence of depression in patients with endometriosis and rheumatoid arthritis. On the basis of the DSM-5 results, patients with concurrent depression were categorized into the observation group, and those without depression were categorized into the control group. The patients' clinical data were collected, and the impact factors were analyzed through binary logistic regression. 

Results: DSM-5 detected 20 patients with depression, with a detection rate of 18.52%. HAMD detected 21 patients with depression, with a detection rate of 19.44%. SDS detected 18 patients with depression, with a detection rate of 16.67%. The difference in the detection rate of depression in patients with endometriosis combined with rheumatoid arthritis among the three methods was not statistically significant (p = 0.865). Binary logistic regression analysis showed that dysmenorrhea (odds ratio (OR) = 3.589, p = 0.005), dyspareunia (OR = 2.964, p = 0.012), Visual Analog Scale score (OR = 2.545, p = 0.001), Disease Activity Score-28 score (OR = 3.828, p = 0.004), Pittsburgh Sleep Quality Index score (OR = 3.942, p = 0.004), and Health Assessment Questionnaire-Disability Index score (OR = 3.527, p = 0.008) were significant influencing factors for depression. 

Conclusion: DSM-5, HAMD, and SDS can be used to detect depression in patients with endometriosis and rheumatoid arthritis as effective tools for depression screening. Dysmenorrhea, dyspareunia, Visual Analog Scale (VAS), Rheumatoid arthritis disease activity (DAS28), Pittsburgh Sleep Quality Index (PSQI), and Health Assessment Questionnaire-Disability Index (HAQ-DI) are influencing factors of depression in these patients.