Emanuela Saita

Impact of endometriosis on quality of life and mental health: pelvic pain makes the difference

Abstract Introduction: No prior study of endometriosis has investigated the psychological impact of having asymptomatic endometriosis versus endometriosis with pelvic pain in a systematic way. This study aimed at examining the impact of endometriosis on quality of life, anxiety and depression by comparing asymptomatic endometriosis, endometriosis with pelvic pain, and healthy, pain-free controls. The psychological impact of different types of endometriosis pain was also tested. Methods: One hundred and ten patients with surgically diagnosed endometriosis (78 with pelvic pain and 32 without pain symptoms) and 61 healthy controls completed two psychometric tests assessing quality of life, anxiety and depression. Endometriosis participants indicated on a numerical rating scale the intensity of four types of pain (dysmenorrhea, dyspareunia, non-menstrual pelvic pain and dyschezia). Results: Endometriosis patients with pelvic pain had poorer quality of life and mental health as compared with those with asymptomatic endometriosis and the healthy controls. No significant differences were found between asymptomatic endometriosis and the control group. Dysmenorrhea had significant effects only on physical quality of life; non-menstrual pelvic pain affected all the variables; no significant effects were found for dyspareunia and dyschezia. Conclusions: Pain significantly affects women’s experience of endometriosis. The medical treatment of endometriosis with pain may not be sufficient and psychological intervention is recommended.

Coping with early stage breast cancer: Examining the influence of personality traits and interpersonal closeness

The study examines the influence of personality traits and close relationships on the coping style of women with breast cancer. A sample of 72 Italian patients receiving treatment for early stage breast cancer was recruited. Participants completed questionnaires measuring personality traits (Interpersonal Adaptation Questionnaire), interpersonal closeness (Inclusion of the Other in the Self Scale), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale). We hypothesized that diverse personality traits and degrees of closeness contribute to determine the coping styles shown by participants. Multiple regression analyses were conducted for each of the five coping styles (Helplessness/Hopelessness, Anxious Preoccupation, Avoidance, Fatalism, and Fighting Spirit) using personality traits and interpersonal closeness variables (Strength of Support Relations, and Number of Support Relations) as predictors. Women who rated high on assertiveness and social anxiety were more likely to utilize active coping strategies (Fighting Spirit). Perceived strength of relationships was predictive of using an active coping style while the number of supportive relationships did not correlate with any of the coping styles. Implications for assessment of breast cancer patients at risk for negative adaptation to the illness and the development of psychosocial interventions are discussed.

“Free butterflies will come out of these deep wounds”: A grounded theory of how endometriosis affects women’s psychological health

This study aimed to develop a grounded theory of how endometriosis affects psychological health. Open interviews were conducted with 74 patients. The Hospital Anxiety and Depression Scale was administered to all women, who were divided into distressed versus non-distressed. At the core of our grounded theory was the notion of disruption due to the common features of living with endometriosis. Experiencing disruption (vs restoring continuity) involved higher distress and was associated with a long pathway to diagnosis, bad doctor–patient relationships, poor physical health, lack of support, negative sense of female identity, and identification of life with endometriosis.

Development and Evaluation of the Cancer Dyads Group Intervention: Preliminary Findings

Despite the fact that importance of primary relationships for cancer patients and their caregivers’ adaptation to illness is well recognized, only a paucity of studies report about clinical interventions for the patient–caregiver dyad. The article presents the Cancer Dyads Group Intervention (CDGI), a supportive group intervention for breast cancer patients and caregivers, and preliminary findings about its effectiveness. A correspondence analysis of the verbatim transcripts of the first three groups was conducted. Findings highlight the evolution of participants during the intervention and confirm the congruence between goals and the participants’ experience. Further investigation of the CDGI effectiveness is necessary.

Fear of childbirth in primiparous Italian pregnant women: The role of anxiety, depression, and couple adjustment

BACKGROUND The prevalence of fear of childbirth in pregnant women is described to be about 20-25%, while 6-10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia. AIMS The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women. METHODS Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth. FINDINGS Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth. CONCLUSIONS Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions.

Trajectories of Postpartum Depression in Italian First-Time Fathers:

Paternal postpartum depression (PPD) has received little attention compared with maternal prenatal and postpartum depression, despite research reporting that paternal PPD concerns a substantial number of fathers. History of depression and antenatal depression have been identified as important PPD’s risk factors, underlining the continuity of depressive symptoms during the transition to parenthood. However, only few studies have focused on the evolution of depressive symptoms with longitudinal research design. The present study aims at analyzing the longitudinal trajectories of depressive symptoms from the third trimester of pregnancy to 1 year after childbirth. One hundred and twenty-six first-time fathers completed the Edinburgh Postnatal Depression Scale at four time points (7-8 months of pregnancy, 40 days, 5-6 months, and 12 months after childbirth). Data were analyzed throughout latent growth mixture modeling. Latent growth mixture modeling analysis indicated a three-class model as the optimal solution. The three-class solution included a trajectory of low, stable depressive symptoms across the four time points (resilient, 52%); a trajectory of moderate, relatively stable depressive symptomatology (distress, 37%); and a trajectory of emergent clinical depression following a pattern of high depressive symptoms (emergent depression, 11%). This study allowed to identify different subpopulation within the sample, distinguishing among mental well-being, emotional distress, and high-risk conditions when—1 year after childbirth—fathers report the highest scores to the Edinburgh Postnatal Depression Scale. These results underline the importance to analyze fathers’ well-being over the time during the transition to fatherhood.

Framed portrait: la fotografia come tecnica narrativa in psico-oncologia. Un’esperienza con soggetti colpiti da tumore sistemico in adolescenza

Questo contributo presenta un intervento psicologico rivolto a giovani adulti che hanno contratto una malattia oncologica sistemica durante l’adolescenza. L’intervento trova il suo fondamento in quattro riferimenti teorici: la specificita della malattia oncologica diagnosticata in adolescenza; il costrutto di body image, per l’importanza che esso riveste in questo periodo dello sviluppo e in ragione di quanto le cure necessarie per combattere la malattia danneggino il corpo; il terzo presupposto riguarda la narrazione autobiografica che facilita la costruzione ermeneutica del senso degli eventi; l’ultimo presupposto rimanda all’utilizzo del ritratto fotografico, esperienza che consente al soggetto di sperimentare ed esprimere emozioni, pensieri e ricordi al fine di una miglior comprensione di se. La delineazione di due casi, corredata da alcuni scatti fotografici completera la descrizione dell’intervento in oggetto.