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Pino I, Belloni GM, Barbera V, Solima E, Radice D, Angioni S, Arena S, Bergamini V, Candiani M, Maiorana A, Mattei A, Muzii L, Pagliardini L, Porpora MG, Remorgida V, Seracchioli R, Vercellini P, Zullo F, Zupi E, Vignali M, Nicola DM, Cecilia B, Alessio P, Paola V, Ludovica B, Jessica O, Matteo S, Domenico I, Walter A, Federica P, Ilaria P, Sara S, Claudia M, Simona DF, Nicola B, Edgardo S, Agnese D, Gabriele C, Lucia L, Luca LB, Caterina E, Giuseppe S, Roberta V. "Better late than never but never late is better", especially in young women. A multicenter Italian study on diagnostic delay for symptomatic endometriosis. EUR J CONTRACEP REPR 2023; 28:10-16. [PMID: 36287190 DOI: 10.1080/13625187.2022.2128644] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of the study was to assess the length of diagnostic delay of symptomatic endometriosis in Italy and analyse the presence of correlations between the socio-demographic status of patients and the clinical characteristics/type of diagnosis. MATERIALS AND METHODS This multicenter cross-sectional questionnaire-based study was conducted in 10 tertiary Italian referral centres for diagnosis and treatment endometriosis. A total of 689 respondents with histologically proven endometriosis and onset of the disease with pain symptoms completed an on-line self-reported questionnaire written in their own language (World Endometriosis Research Foundation-Endometriosis Phenome and Biobanking Harmonisation Project-Endometriosis Patient Questionnaire-Minimum) evaluating endometriosis related symptoms, family history of endometriosis and chronic pelvic pain, demographic data, as well as medical, reproductive, and obstetric history. RESULTS The mean diagnostic delay found was of 11.4 years. The mean time (14.8 years) from symptoms onset to diagnosis was significantly longer among patients aged 9-19 vs patients aged 20-30 (mean 6.9 years, p < 0.001) and patients aged 31-45 (mean 2.9, p < 0.001). No significant association were found between a delayed diagnosis and any of the clinically relevant factors such as the number or severity of the reported symptoms, familiarity, hormonal therapy intake or methodology of diagnosis. CONCLUSIONS The mean diagnostic delay of endometriosis in Italy is about 11 years. The delay can be up to 4 years longer in patients with pain symptoms onset under 20 years. Educating clinicians and patients on pathologic nature of endometriosis related pelvic pain is advisable to reduce waiting time to diagnosis, especially for young women.
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Affiliation(s)
- Ida Pino
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | - Gaia Maria Belloni
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Valeria Barbera
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Eugenio Solima
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Davide Radice
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Angioni
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Saverio Arena
- Department of Obstetrics and Gynecology, Azienda Ospedaliera of Perugia, Perugia, Italy
| | - Valentino Bergamini
- Department of Obstetrics and Gynecology Verona, University of Verona, Verona, Italy
| | - Massimo Candiani
- Gynecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Maiorana
- Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy
| | - Alberto Mattei
- Division of Gynaecology and Obstetrics, Santa Maria Annunziata Hospital, USL Toscana Centro, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urology, University of Rome "Sapienza", Policlinico "Umberto I", Roma, Italy
| | - Luca Pagliardini
- Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria Grazia Porpora
- Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valentino Remorgida
- Academic Unit of Obstetrics and Gynecology, Ospedale Policlinico San Martino and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Renato Seracchioli
- Gynaecology and Human Reproduction Physiopathology Unit, Department of Medical and Surgical Sciences, DIMEC, S.Orsola Hospital, University of Bologna, Bologna, Italy
| | - Paolo Vercellini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano and Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Errico Zupi
- Gynecology Department, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Michele Vignali
- Department of Obstetrics and Gynecology, Macedonio Melloni Hospital and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | | | - Bonin Cecilia
- Department of Obstetrics and Gynecology, Azienda Ospedaliera of Perugia, Perugia, Italy
| | - Perandini Alessio
- Department of Obstetrics and Gynecology, Azienda Ospedaliera of Perugia, Perugia, Italy
| | - Viganò Paola
- Department of Obstetrics and Gynecology Verona, University of Verona, Verona, Italy
| | - Bartiromo Ludovica
- Department of Obstetrics and Gynecology Verona, University of Verona, Verona, Italy
| | - Ottolina Jessica
- Department of Obstetrics and Gynecology Verona, University of Verona, Verona, Italy
| | - Schimberni Matteo
- Department of Obstetrics and Gynecology Verona, University of Verona, Verona, Italy
| | - Incandela Domenico
- Gynecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alio Walter
- Gynecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Perelli Federica
- Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy
| | - Piacenti Ilaria
- Division of Gynaecology and Obstetrics, Santa Maria Annunziata Hospital, USL Toscana Centro, Florence, Italy
| | - Scaramuzzino Sara
- Division of Gynaecology and Obstetrics, Santa Maria Annunziata Hospital, USL Toscana Centro, Florence, Italy
| | - Massarotti Claudia
- Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Del Forno Simona
- Academic Unit of Obstetrics and Gynecology, Ospedale Policlinico San Martino and Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Berlanda Nicola
- Gynaecology and Human Reproduction Physiopathology Unit, Department of Medical and Surgical Sciences, DIMEC, S.Orsola Hospital, University of Bologna, Bologna, Italy
| | - Somigliana Edgardo
- Gynaecology and Human Reproduction Physiopathology Unit, Department of Medical and Surgical Sciences, DIMEC, S.Orsola Hospital, University of Bologna, Bologna, Italy
| | - Donati Agnese
- Gynaecology and Human Reproduction Physiopathology Unit, Department of Medical and Surgical Sciences, DIMEC, S.Orsola Hospital, University of Bologna, Bologna, Italy
| | - Centini Gabriele
- Gynecology Department, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Lazzeri Lucia
- Gynecology Department, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - La Banca Luca
- Gynecology Department, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Exacoustos Caterina
- Department of Biomedicine and Prevention, Obstetrics and Gynecological Unit, University of “Tor Vergata”,, Rome, Italy
| | - Sorrenti Giuseppe
- Department of Gynecology and Obstetric Unit, Hospital Casilino, Rome, Italy
| | - Venturella Roberta
- Department of Clinical and Experimental Medicine – Magna Graecia University of Catanzaro, Italy
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Barone E, Marciello F, Cascino G, Abbate-Daga G, Anselmetti S, Baiano M, Balestrieri M, Bertelli S, Carpiniello B, Castellini G, Corrivetti G, De Giorgi S, Favaro A, Gramaglia C, Marzola E, Monaco F, Oriani M, Federica P, Rania M, Renna C, Ricca V, Salvo P, Segura-Garcia C, Scarabel F, Todisco P, Volpe U, Zeppegno P, Monteleone P, Monteleone A. COVID-19 pandemic and eating disorders: What impact on specific and general psychopathology? Eur Psychiatry 2021. [PMCID: PMC9471239 DOI: 10.1192/j.eurpsy.2021.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic and the resulting containment measures, such as “lockdown” and “social distancing”, have had important consequences on people’s mental and physical health. Objectives We aimed to study the effect of social isolation and subsequent re- exposure and eventual changes in general and ED-specific psychopathology in people with Eating Disorders (EDs). Methods Three-hundred twelve Italian people with EDs (179 Anorexia Nervosa, 83 Bulimia Nervosa, 48 Binge Eating Disorder and 22 Other Specific Feeding Eating Disorder) were asked to fill-in an online survey to explore several dimensions such as: anxiety, depression, panic, insomnia, suicide ideation, stress, post-traumatic stress and obsessive-compulsive symptoms. Differences in ED specific and general symptoms among the 3 investigated time periods (before, during and after the end of lockdown) were assessed with a one-way ANOVA with repeated measures. Subsequently, ED diagnosis was introduced as covariate in the analysis in order to investigate the possible contribution on psychopathological changes. Results ED core symptoms increased during the lockdown but most of them returned to pre-COVID19 levels at re-opening. The severity of general psychopathology also increased during the lockdown and persisted high in the following phase, except for depression and suicide ideation. None of this symptoms was affected by ED diagnosis, participants’age and illness duration. Conclusions People with EDs showed worsening of both general and specific psychopathology; moreover, changes in general psychopathology persisted in the re-opening period suggesting a higher stress vulnerability in this kind of patients. Disclosure No significant relationships. Keyword COVID19 and Eating Disorders
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