Prevalence of Pain Syndromes, Mood

Conditions, and Asthma in

Adolescents and Young Women with
Endometriosis

Critical Appraisal By: Adalid Ballesteros, Ana Lopez, Jessica Romero, Laura
Rebolledo
 Introduction
Problem studied Endometriosis

Research Question/Hypothesis Association between endometriosis and comorbid pains, mood changes and
autoimmune/ atopic situations?

Aim of the Study Evaluation- frequency of comorbid pain syndromes, the state of mood
changes and several autoimmune and atopic situations, in pubescent and
young women, who have been diagnosed with the disease itself.

Comparison- clinical and surgical traits of participants who have and do

not have these pain syndromes.
 Methods
TYPE OF
STUDY
Retrospective/Observational

VARIABLES ANALYZED
● Comorbid pain syndromes ( Fibromyalgia, irritable bowel
syndrome)
● Mood changes (anxiety, depression)
● Different autoimmune and atopic situations (asthma,
allergies,lupus)
NUMBER OF OBSERVATIONS MADE
Not Listed
STUDY SAMPLE
● 138 Participants
○ Adolescents and young women
● Medical Records
○ Of the 138 participants
○ From the University of Michigan Medical
Center and outside institutions
● Inclusion criteria
○ Must have been younger than the age of 24
PRIOR to first visit to medical center
○ Must have been surgically diagnosed with
endometriosis by the age of 21
○ Surgical diagnosis: visual confirmation
● Exclusion Criteria
○ Medical records with unclear diagnosis
○ Incomplete records
○ Endometriosis caused by obstructive Mullerian
anomalies
RESULTS

● 56% of patients had at least 1 comorbid

pain syndrome
● 27% of patients had 2 or more pain
syndromes
● 48% of patients experienced depression
and/or anxiety
 MEASURES
Medical reports reviewed for operative pathology
reports
● Identify those with surgical diagnoses
Other information collected:
● Demographics
● Symptoms
● Any other medical diagnoses, pain syndromes,
and surgical history
● Current and past treatments for endometriosis
MEASURES
● Stages of endometriosis categorized among
participants was defined by the American Society
for Reproductive Medicine classification.
○ Records with no clear distinction for category
were labeled as ‘unknown’.
● A standardized data sheet was utilized for the data
abstraction.
● Smorgick et al. (2013) determined prevalence of
comorbid pain syndromes, mood conditions,
and asthma through the medical records.
 DATA ANALYSIS

STATISTICAL STATISTICAL
PACKAGE TECHNIQUES
● Non-parametric Mann-Whitney rank
SPSS
test
● Chi-square test
● Odds ratio
● Confidence interval of 95% for
differences considered important in the
DISCUSSION
CONCLUSION
● Comorbid pain syndromes, mood
conditions, and asthma are common

● 56% of patients had at least 1 comorbid

pain syndrome, and 27% had 2 or more pain
syndromes, and depression and anxiety
occurred in 48% of patients had
depression/anxiety
DISCUSSION
CONCLUSION
● Patients with any kind of comorbid pain
syndrome were more likely to smoke,
whereas patients with concomitant mood
disorders are more likely to use two or more
different medications

● Monitor for mood conditions and if they are

present, then treatment should be
administered
DISCUSSION
CONCLUSION
● Research design differs from other studies
because it focuses on adolescents and young
adults, whereas previous studies focused on
older women

● Retrospective medical record review, short

follow up period and the results may reflect
smaller than accurate percentages.

● Data was from patient’s medical records

that include self-reported diagnoses
DISCUSSION
CONCLUSION
● Small sample size of young women,
autoimmune disorders are diagnosed later
in life.

● If the researchers purpose is to improve any

quality of life, screening for the presence of
mood conditions with appropriate follow-up
treatment is recommended.
 REFLECTION
● Important study for vulnerable populations - women and female-born individuals
● Usage of visual aids to outline results efficiently
● Condensed to minimal pages - easy to follow
 REFERENCES
● Smorgick, N., Marsh, C. A., As-Sanie, S., Smith, Y. R., & Quint, E. H. (2013, June).
Prevalence of Pain Syndromes, Mood Conditions, and Asthma in Adolescents and Young
Women with Endometriosis. Journal of Pediatric and Adolescent Gynecology, 26(3), 171–
175. https://doi.org/10.1016/j.jpag.2012.12.006

THANKS!