PSYCHOLOGICAL FACTORS AND GYNECOLOGICAL DISEASE

心理因素与妇科疾病

• 批准号: 7718739
• 负责人: ROBERT G BRZYSKI
• 金额: $ 0.03万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7718739
• 关键词: Age; Age-Years; Androgens; Anxiety; Biochemical Markers; Body mass index; Caring; Clinic; Clinical; Computer Retrieval of Information on Scientific Projects Database; Control Groups; Depression screen; Discipline of obstetrics; Disease; Emotional; Enrollment; Epidemiologic Studies; Female Genital Diseases; Frequencies; Funding; Gonadotropins; Grant; Gynecologic; Hirsutism; Infertility; Inpatients; Institution; Insulin Resistance; Laboratories; Laparoscopy; Measures; Mental Depression; Mental disorders; Obesity; Outpatients; Pathologic; Patients; Pelvic Pain; Polycystic Ovary Syndrome; Post-Traumatic Stress Disorders; Prevalence; Psychiatric Diagnosis; Psychiatry; Psychological Factors; Publishing; Recording of previous events; Reporting; Research; Research Personnel; Resources; Score; Screening procedure; Series; Serum; Severities; Severity of illness; Source; Sterilization for infection control; Symptoms; United States National Institutes of Health; Woman; chronic pain; chronic pelvic pain; clinically relevant; comparison group; day; improved; psychologic; tool

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. OBJECTIVES: 1) To evaluate the prevalence and severity of psychological symptoms in gynecologic patients with chronic pelvic pain (CPP) or polycystic ovary syndrome (PCOS). 2) To correlate the severity of the psychological symptoms with clinical and laboratory measures of the severity of the gynecologic disease. RESEARCH PLAN: In this study we will administer the Havard Department of Psychiatry/National Depression Screening Day Scale (HANDS) psychological screening tool and/or the Center for Epidemiologic Studies-Depression (CES-D) scale to gynecologic patients. Women over 18 years of age seen in our gynecologic inpatient or outpatient settings or enrolled in ongoing studies will be invited to participate. METHODS: For the portion of the study involving PCOS, scores on the HANDS screening tool and/or the CES-S scale will be compared to scores for age and body mass index (BMI) matched controls as well as for age-matched controls with infertility. HANDS and/or CES-D score in PCOS patients will also be correlated with measures of disease severity including BMI, menstrual frequency, obstetric history, hirsutism score, serum androgens, serum gonadotropins and insulin resistance. These measures of severity will be obtained from patient charts. For the portion of the study involving CPP, the HANDS screening tool will be administered to women with CPP undergoing diagnostic laparoscopy as part of routine clinical care. The screening tool will also be administered to two control groups: 1) women without pelvic pain undergoing elective laparoscopic sterilization and 2) women without pelvic pain seen in our patient clinics. Scores between groups will be compared. Scores will also be correlated with pathologic findings at laparoscopy. CLINICAL RELEVANCE: Half of gynecologic outpatients have a significant emotional disease. Psychiatric diagnoses are common features of many gynecologic diseases. For example, depression scores on screening tools are higher in women with polycystic ovary syndrome (PCOS) compared to age matched healthy controls, and depression is frequently reported in published series of women with chronic pelvic pain (CPP). While the existence of depression in gynecologic patients is clear, the comparison groups in studies are frequently not optimally selected. For example, since obesity and infertility are common features of PCOS and since depression may be more prevalent in these populations, obese women and infertile women may be better control groups. It is also unclear whether depression is a result of chronic pain or causally related. Depression has also been shown to correlate with clinical and biochemical markers of gynecologic disease, however, it is unknown whether treating the gynecologic disease improves depression. We hypothesize that psychological disorders, such as depression, anxiety and post-traumatic stress disorder (PTSD) are more common in certain gynecologic diseases, such as chronic pelvic pain (CPP) and polycystic ovary syndrome (PCOS), and these psychological disorders correlate with measures of severity in the gynecologic diseases.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 目的： 第一章 目的探讨慢性盆腔痛（CPP）和多囊卵巢综合征（PCOS）妇科患者心理症状的发生率和严重程度。 （二） 将心理症状的严重程度与妇科疾病严重程度的临床和实验室指标相关联。 研究报告：在这项研究中，我们将管理哈佛精神病学部/国家抑郁症筛查日量表（HANDS）的心理筛查工具和/或流行病学中心抑郁症（CES-D）规模的妇科患者。 将邀请在我们的妇科住院或门诊就诊或入组正在进行的研究的18岁以上女性参加。 方法：对于涉及PCOS的研究部分，将HANDS筛查工具和/或CES-S量表的评分与年龄和体重指数（BMI）匹配的对照组以及年龄匹配的不孕症对照组的评分进行比较。 PCOS患者的HANDS和/或CES-D评分也将与疾病严重程度的测量相关，包括BMI、月经频率、产科史、多毛症评分、血清雄激素、血清促性腺激素和胰岛素抵抗。 这些严重度指标将从患者病历中获得。 对于涉及CPP的研究部分，作为常规临床护理的一部分，将对接受诊断性腹腔镜检查的CPP女性使用HANDS筛选工具。 筛选工具还将用于两个对照组：1）接受择期腹腔镜绝育术的无盆腔疼痛的女性和2）在我们的患者诊所中看到的无盆腔疼痛的女性。 将比较组间评分。 评分还将与腹腔镜检查的病理结果相关。 临床相关性：一半的妇科门诊患者有明显的情绪疾病。 精神病诊断是许多妇科疾病的共同特征。 例如，与年龄匹配的健康对照相比，多囊卵巢综合征（PCOS）女性的筛查工具抑郁评分更高，并且抑郁症经常在慢性盆腔疼痛（CPP）女性的已发表系列中报道。 虽然妇科患者中抑郁的存在是明确的，但研究中的对照组往往没有最佳选择。 例如，由于肥胖和不孕是PCOS的常见特征，并且由于抑郁症在这些人群中可能更普遍，因此肥胖妇女和不孕妇女可能是更好的对照组。 目前还不清楚抑郁症是否是慢性疼痛的结果或因果关系。 抑郁症也被证明与妇科疾病的临床和生化标志物相关，然而，治疗妇科疾病是否能改善抑郁症尚不清楚。 我们假设心理障碍，如抑郁，焦虑和创伤后应激障碍（PTSD）在某些妇科疾病中更常见，如慢性盆腔疼痛（CPP）和多囊卵巢综合征（PCOS），这些心理障碍与妇科疾病的严重程度相关。