Table 2.
Association Between Endometriosis and Anxiety, Depression, and Self-Directed Violence, Overall and Stratified by Age Group (n = 219,918), Optum Clinformatics DataMart, 2000–2019a
| Exposure Status | No. | No. of Events | Incidence Per 1,000 PY | Crude | Multivariable Model 1b | Multivariable Model 2c | |||
|---|---|---|---|---|---|---|---|---|---|
| HR | 95% CI | HR | 95% CI | HR | 95% CI | ||||
| Incident Anxiety | |||||||||
| Overall | |||||||||
| Endometriosis | 72,677 | 8,377 | 57.1 | 1.42 | 1.38, 1.45 | 1.38 | 1.34, 1.42 | 1.25 | 1.21, 1.29 |
| No endometriosis | 147,251 | 14,840 | 39.8 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age 18–34 years | |||||||||
| Endometriosis | 38,741 | 4,875 | 64.5 | 1.43 | 1.38, 1.48 | 1.36 | 1.31, 1.41 | 1.35 | 1.30, 1.40 |
| No endometriosis | 75,931 | 7,833 | 44.4 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age 35–50 years | |||||||||
| Endometriosis | 33,936 | 3,502 | 49.3 | 1.37 | 1.31, 1.42 | 1.35 | 1.29, 1.41 | 1.34 | 1.28, 1.39 |
| No endometriosis | 71,320 | 7,007 | 35.6 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Incident Depression | |||||||||
| Overall | |||||||||
| Endometriosis | 72,677 | 7,105 | 47.7 | 1.48 | 1.44, 1.52 | 1.48 | 1.44, 1.53 | 1.31 | 1.27, 1.36 |
| No endometriosis | 147,251 | 11,933 | 31.5 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age 18–34 years | |||||||||
| Endometriosis | 38,741 | 4,287 | 56.1 | 1.56 | 1.50, 1.63 | 1.52 | 1.46, 1.59 | 1.50 | 1.44, 1.56 |
| No endometriosis | 75,931 | 6,289 | 35.1 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age 35–50 years | |||||||||
| Endometriosis | 33,936 | 2,818 | 38.9 | 1.35 | 1.29, 1.41 | 1.38 | 1.31, 1.45 | 1.34 | 1.28, 1.41 |
| No endometriosis | 71,320 | 5,644 | 28.3 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Incident Self-Directed Violence | |||||||||
| Overall | |||||||||
| Endometriosis | 72,677 | 151 | 0.91 | 2.32 | 1.86, 2.90 | 2.03 | 1.60, 2.58 | 1.70 | 1.30, 2.23 |
| No endometriosis | 147,251 | 162 | 0.39 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age 18–34 years | |||||||||
| Endometriosis | 38,741 | 101 | 1.17 | 2.39 | 1.80, 3.16 | 1.98 | 1.47, 2.67 | 3.26 | 1.92, 5.53 |
| No endometriosis | 75,931 | 96 | 0.49 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
| Age 35–50 years | |||||||||
| Endometriosis | 33,936 | 50 | 0.63 | 2.09 | 1.45, 3.02 | 1.83 | 1.23, 2.72 | 2.01 | 1.02, 3.95 |
| No endometriosis | 71,320 | 66 | 0.30 | 1.00 | Referent | 1.00 | Referent | 1.00 | Referent |
Abbreviations: CI, confidence interval; HR, hazard ratio; PY, person-years.
a Patients began follow-up 1 day after cohort entry and were censored on occurrence of the outcome, hysterectomy, death, disenrollment, or end of data.
b Multivariable model 1 was adjusted for race/ethnicity, region of residence, uterine fibroids, chronic headaches (including migraine), chronic lower back pain, fibromyalgia, asthma, type 2 diabetes mellitus, fatigue, hypertension, hypothyroidism, vitamin D deficiency, and use of opioid analgesics, antihypertensives, and corticosteroids.
c Multivariable model 2 was adjusted for race/ethnicity, region of residence, hypothyroidism, vitamin D deficiency, and use of opioid analgesics, antihypertensives, and corticosteroids.