Neuroticism and cognitive correlates of depression and anxiety in endometriosis: A meta-analytic review, evidence appraisal, and future recommendations

R A Davenport; I Krug; P L Dang; N Rickerby; L Kiropoulos

doi:10.1016/j.jpsychores.2024.111906

Neuroticism and cognitive correlates of depression and anxiety in endometriosis: A meta-analytic review, evidence appraisal, and future recommendations

J Psychosom Res. 2024 Dec:187:111906. doi: 10.1016/j.jpsychores.2024.111906. Epub 2024 Aug 30.

Authors

R A Davenport¹, I Krug², P L Dang², N Rickerby³, L Kiropoulos²

Affiliations

¹ Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia. Electronic address: davenportr@student.unimelb.edu.au.
² Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.
³ School of Psychology, The University of Queensland, Brisbane, Australia.

PMID: 39236356
DOI: 10.1016/j.jpsychores.2024.111906

Abstract

Objective: This meta-analytic review aimed to synthesise evidence on personality and cognitive factors related to depression and anxiety in endometriosis and determine whether sociodemographic and clinical variables moderate factor-symptom relations. Additionally, this review aimed to evaluate the quality of research and formulate recommendations for future research.

Methods: A systematic search was conducted across databases (Medline, Embase, PsycInfo, Web of Science, ProQuest) through to February 2024. Search terms were used for endometriosis, depression, anxiety, cognitive factors and personality traits. Random-effects meta-analyses were conducted to produce pooled weighted effects (r) for factor-symptom relationships.

Results: Thirteen studies (11 samples; N = 3287; M_age 33.89 ± 2.48) were included in a narrative synthesis. One study provided evidence for a positive association between neuroticism and depression. Seven studies contributed to meta-analyses on three cognitive factors. Medium-to-large associations were identified between illness perceptions of low control/power (r = 0.35, 95 % CI: 0.01,0.62), rumination (r = 0.52, 95 % CI: 0.09, 0.78), pain-catastrophising (r = 0.37, 95 % CI: 0.28, 0.45) and higher levels of depression. The statistical power to detect significant effects was >80 %. Findings for anxiety were non-significant, although limited data were available. Quality appraisal revealed a high risk of within-study bias (4.69 ± 1.38, range: 3-7), with issues related to sample representativeness and measurement selection.

Conclusion: Rumination, pain-catastrophising, and illness perceptions of low control/power are important in understanding depression in endometriosis. There is a lack of research on personality traits, necessitating further study. Findings highlight the importance of prioritising modifiable cognitive factors in psychological research and clinical practice in endometriosis.

Keywords: Anxiety; Cognitive factors; Depression; Endometriosis; Personality; meta-analysis.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Anxiety / psychology
Cognition
Depression* / psychology
Endometriosis* / complications
Endometriosis* / psychology
Female
Humans
Neuroticism*
Personality