Poor mental health is prevalent among individuals with long-term conditions, especially those with chronic pain like endometriosis. Furthermore, quality of life is negatively impacted by chronic pain. Endometriosis is a whole-body disease, with the same prevalence as diabetes, yet it is under-funded and under-researched, resulting in increased morbidity in individuals with the disease. It is characterised by endometrial-like tissue growing outside the uterus, with high levels of chronic pain and often leads to gastrointestinal symptoms even without Bowel Endometriosis. Poor mental health in patients with Endometriosis has been found to exacerbate symptoms, creating a vicious cycle. Factors such as medical gaslighting and delays in diagnosis and treatment as well as psychosocial impact like loss of identity, loss of social connection, reductions in physical activity and changes in dietary behaviours have significant influences on mental health in this population. Limiting specific foods or whole food groups are changes in dietary behaviour change that can result in nutritional inadequacy, further impacting mental health. Therefore, this project aims to explore and collate the known relationships between mental health and wellbeing in endometriosis and develop priority areas for research. The project has the potential to inform future public health, clinical treatment pathways, policy guidelines and drive research to inform the best support and care for this neglected population.
The project will use a range of methods providing the candidate with a holistic range of research skills enhancing their career prospects. The skills learnt will be (1) systematic and umbrella review skills, (2) data extraction and analysis of electronic health records, (3) qualitative interview; generation, collation and refinement skills to determine priority research areas.
Overarching objectives:
Year 1: Conduct a comprehensive review of reviews (Umbrella review) on the bi-directional relationship between mental health and Endometriosis focusing on aetiology and symptom management particularly in relation to pain, quality of life, dietary behaviours and gastrointestinal issues. This will allow the candidate to develop a deep understanding of the evidence and research gaps in this important area of Women’s health.
Year 2: Undertake a service evaluation through data extraction and analysis of hospital collected data on mental health, gastrointestinal symptoms and endometriosis, providing the student with analytical skills and real-world evidence.
Year 3: Determine research priorities with patient, public and clinician involvement and engagement using an E-Delphi approach.
Year 4: Write up findings for publication in peer-reviewed journals/disseminate at conferences.