Is adenomyomatosis associated with depression?

From the Guidelines

Adenomyomatosis is not directly associated with any specific psychiatric disorder. The provided evidence [ 1 ] discusses the comorbidities associated with atopic dermatitis, including depression and anxiety, but does not mention adenomyomatosis.

Key Points

• Adenomyomatosis is a benign condition primarily affecting the gallbladder, characterized by an overgrowth of the organ's muscular wall and the formation of small outpouchings called Rokitansky-Aschoff sinuses.
• This condition is considered a physical disorder of the gallbladder and biliary system rather than having psychiatric manifestations or associations.
• While patients with adenomyomatosis may experience physical symptoms such as abdominal pain, these symptoms are not linked to psychiatric conditions.
• Any psychological distress experienced by patients with adenomyomatosis would typically be secondary to dealing with a chronic medical condition rather than representing a direct pathophysiological relationship between adenomyomatosis and psychiatric disorders.

Considerations

• If a patient with adenomyomatosis is experiencing psychiatric symptoms, these should be evaluated and treated independently as they likely represent separate clinical entities.
• The evidence [ 1 ] highlights the importance of considering comorbidities in patients with chronic conditions, but it does not provide a direct link between adenomyomatosis and psychiatric disorders.

From the Research

Adenomyomatosis and Psychiatric Disorders

• Adenomyosis is associated with a higher risk of anxiety and depression, with a poorer quality of life, as compared to uterine leiomyoma 2
• The incidence of anxiety symptoms in patients with adenomyosis is 28.9%, with 10% of patients showing moderate-to-severe symptoms 2
• The incidence of depressive symptoms in patients with adenomyosis is 14.4% 2
• Risk factors for anxiety in patients with adenomyosis include being employed and perianal pain, while perianal pain is a risk factor for depression 2

Psychiatric Disorders

• Depression is the most prevalent psychiatric disorder in the world, affecting 4.4% of the global population 3
• Selective serotonin reuptake inhibitors (SSRIs) are a mainstay of treatment for various psychiatric disorders, including major depression, dysthymia, panic disorder, obsessive-compulsive disorder, eating disorders, and premenstrual dysphoric disorder 3, 4
• SSRIs have a unique mechanism of action, pharmacokinetics, pharmacodynamics, and side effect profile 3, 4

Adenomyomatosis Diagnosis and Management

• Adenomyosis is a clinical condition characterized by the presence of endometrial glands in the myometrium of the uterus 5, 6
• The most common presenting signs and symptoms of adenomyosis are abnormal uterine bleeding, chronic pelvic pain, and infertility 5, 6
• Diagnosis of adenomyosis begins with clinical suspicion and is confirmed with transvaginal ultrasonography and pelvic magnetic resonance imaging 5
• Treatment of adenomyosis typically starts with hormonal menstrual suppression, and patients may ultimately have a hysterectomy if symptoms are not controlled with medical therapy 5