Luigi Frigerio

Journal: Journal of Affective Disorders (In Press November 2024) Zarbo Cristina,  Alessandra Santona; Laura Antonia Lucia Parolin; Rita Secomandi; Ilario Candeloro; Chiara Malandrino; Luigi Frigerio
Manuscript Number: JAFD-D-24-08776 Women with endometriosis are known to be at risk for poor mental health. However, little is known about the suicidal ideation occurrence in this population. The aim of this manuscript - which includes two studies - is twofold: (i) to investigate the differences in suicidal ideation frequencies between women with (EN) and without (CG) endometriosis; and (ii) to identify which clinical, cognitive and relational factors are associated with suicidal ideation in EN group.

Methods: Study 1 included 171 EN and 62 CG participants, who completed the Patient Health Questionnaire 9 (PHQ9), the Short-Form McGill Pain Questionnaire (MPQ-short), and the Cognitive Emotion Regulation Questionnaire - Short Version (CERQ-short). Study 2 included 38 EN and 71 CG participants, who completed the Clinical Outcomes in Routine Evaluation 10 (CORE-10), the Experience in Close Relationship-12 (ECR-12) and the Multidimensional Mentalizing Questionnaire (MMQ). Both studies included sociodemographic and clinical forms. Statistical analyses included chi-square test and stepwise linear regressions.

Results: About 20% of the EN group reported suicidal ideation, with a frequency of occurrence significantly higher than CG (Study 1: x²=4.56; p=.03; Study 2: x²=9.88; p=.002). EN with suicidal ideation, when compared to EN without suicidal ideation, showed lower perceived health (study 1: p=.018; study 2: p=.006), as well as higher occurrence of backache (p=.031), surgeries for endometriosis (p=0.040), and lifetime abortion (p=.043). Moreover, higher levels of self-blame (β=.240), pain (β= .181) and ECR-12 Avoidance (β=.401) predicted a higher frequency of suicidal ideation among the EN group; conversely, higher levels of acceptance (β=-.2553) and health (β=-.342) influenced for a lower frequency of suicidal ideation.

Discussion: Two out of ten women with a diagnosis of endometriosis have suicidal ideation. Several clinical, relational and cognitive factors influence suicidal ideation and should be kept into account to reduce the risk of suicidal behaviours among this vulnerable population.

Keywords: Endometriosis, suicide, pain, attachment, mental health, coping.

Stopping suffering: an exploration of suicidal ideation and its clinical, cognitive and relational correlates among women with a diagnosis of Endometriosis.