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利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 目标： 1)了解妇科慢性盆腔疼痛(CPP)和多囊卵巢综合征(PCOS)患者心理症状的发生率和严重程度。 2)将心理症状的严重程度与妇科疾病的临床和实验室指标进行相关性分析。 研究计划：在本研究中，我们将使用哈瓦德精神病科/全国抑郁症筛查日量表(HANDS)心理筛查工具和/或流行病学研究中心抑郁量表(CES-D)对妇科患者进行评估。18岁以上的女性在我们的妇科住院或门诊设置中或在正在进行的研究中登记，将被邀请参加。 方法：对于涉及多囊卵巢综合征的研究部分，将手筛查工具和/或CES-S量表的得分与年龄和体重指数匹配的对照组以及年龄匹配的不孕症对照组的得分进行比较。PCOS患者的手和/或CES-D评分也将与疾病严重程度的衡量标准相关，包括体重指数、月经频率、产科病史、多毛评分、血清雄激素、血清促性腺激素和胰岛素抵抗。这些严重程度的测量将从患者病历中获得。 对于涉及CPP的研究部分，手筛查工具将用于接受诊断性腹腔镜检查的CPP妇女，作为常规临床护理的一部分。该筛查工具还将应用于两个对照组：1)没有盆腔疼痛的妇女接受选择性腹腔镜绝育手术，以及2)在我们的患者诊所看到的没有盆腔疼痛的妇女。小组之间的分数将被比较。评分也将与腹腔镜术的病理结果相关联。 临床意义：一半的妇科门诊患者有明显的情绪性疾病。精神病学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组相比，患有多囊卵巢综合征(PCOS)的女性在筛查工具上的抑郁得分更高，并且在已发表的慢性盆腔疼痛(CPP)女性系列中经常报告抑郁。虽然妇科患者存在抑郁症是显而易见的，但研究中的对照组往往不是最佳选择。例如，由于肥胖和不孕不育是多囊卵巢综合征的共同特征，而且抑郁症在这些人群中可能更普遍，肥胖妇女和不孕妇女可能是更好的对照组。目前也不清楚抑郁症是慢性疼痛的结果还是因果关系。抑郁症也被证明与妇科疾病的临床和生化标记物相关，然而，治疗妇科疾病是否能改善抑郁症还不清楚。 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。