Psychosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain

Abstract

Chronic pelvic pain is a common clinical problem, and physical investigation often fails to reveal its cause. For this reason, it has been argued that psychological and social factors contribute to such "unexplained" pain. Few studies to date using well-validated psychometric measures and adequate sample sizes have compared patients with unexplained pain and those with identified physical disease. The present study compared pain severity, mood symptoms, personality characteristics and social adjustment in women with unexplained pain and women with endometriosis. Women with endometriosis were more likely to come from upper socioeconomic groups. No differences in mood symptoms or personality characteristics were identified, but women with endometriosis had somewhat more severe pain and greater social dysfunction than those with unexplained pain. Mood disorder and social dysfunction appear to be at least as important in patients with proven endometriosis as in those with unexplained pain.