Improving the quality of life: The role of cognitive behavioral therapy after endometriosis surgery

Cognitive behavioral therapy enhances mental well-being in endometriosis patients after surgery

Key Points

Highlight

• Combining cognitive behavioral therapy with usual care improves mental health outcomes in patients with endometriosis after surgery.

Importance

• Endometriosis is associated with poor mental health and reduced quality of life.
• Surgery for endometriosis may not fully restore a patient's quality of life, necessitating additional interventions.

What's done here

• This is a preliminary case-control study aiming to determine if combining usual care with cognitive behavioral therapy can improve depression, anxiety, and stress in endometriosis patients after surgery compared to usual care alone.
• Patients diagnosed with endometriosis aged 18-50 were randomly assigned to a cognitive behavioral therapy intervention group or a control group.
• Cognitive behavioral therapy sessions focused on education, behavior modification, and self-protection activities.
• Depression, anxiety, and stress were measured using the appropriate scientific scale.

Key points

• Both the intervention group and the control group showed a significant decrease in depression, anxiety, and stress scores after the intervention.
• The intervention group exhibited a higher reduction in anxiety scores compared to the control group.
• The number of patients with no symptoms of depression increased significantly in the intervention group.
• Providing patients with information about endometriosis and behavior interventions contributed to improved mental health outcomes.
• The support of family, friends, and medical personnel played a role in enhancing mental well-being.

Limitations

• A relatively brief intervention period, the lack of long-term follow-up and the small sample size are the limitations.

Lay Summary

Endometriosis and its symptoms have been associated with poor mental health and reduced quality of life. Cognitive behavioral therapy is recognized as an effective psychological treatment for managing depression, anxiety, and stress. Although surgery for endometriosis improves a patient's quality of life, it may not reach the same level as that of a healthy woman. To bridge this gap, Wu et al. from China conducted a preliminary case-control study aiming to determine if combining usual care with cognitive behavioral therapy has an additional effect on endometriosis patients after surgery compared to usual care alone. The study was published in the journal Medicine (Baltimore).

Patients who were previously diagnosed with endometriosis aged between 18-50 were included and randomly assigned to either a Cognitive behavioral therapy intervention group or a control group. Therapy sessions focused on education, behavior modification, and self-protection activities. Depression, anxiety, and stress were measured using the DASS-21 scale. Statistical analyses were performed to compare the groups. A total of 96 patients participated in the study. Both the intervention group, receiving Cognitive behavioral therapy, and the control group, receiving usual care alone, showed similar socio-demographic and clinical characteristics. 

It is stated that both groups experienced a significant decrease in depression, anxiety, and stress scores after the surgery. The intervention group exhibited a higher reduction in anxiety scores compared to the control group. Additionally, the number of patients with no symptoms of depression increased significantly in the intervention group compared to baseline. The intervention also led to a decrease in the number of patients with symptoms of extremely severe anxiety, although this was not statistically significant. In contrast, the control group showed an increase in mild anxiety, however, not statistically significant. The number of patients with extremely severe stress decreased in the control group but also was not significant.

It was shown that providing patients with sufficient information about endometriosis and its management, along with behavior interventions such as self-protection skills and relaxation techniques, can contribute to improved psychological health. The support of family, friends, and medical personnel also played a role in enhancing mental well-being.

The authors indicate the potential of Cognitive behavioral therapy in improving mental health outcomes for patients who have undergone endometriosis surgery and state that the results align with previous research highlighting the effectiveness of Cognitive behavioral therapy in reducing depression, anxiety, and stress symptoms. Further well-designed randomized controlled trials are needed to build upon these preliminary findings and provide a more comprehensive understanding of the impact in the context of endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/36595829/