Background: Endometriosis is a pathophysiological condition characterized by glands and stroma outside the uterus in regions such as the bladder, ureter, fallopian tubes, peritoneum, ovaries, and even in extra pelvic sites. One of the main clinical problems of endometriosis is chronic pelvic pain (CPP), which considerably affects the patients’ quality of life. Patients with endometriosis may, cyclically or non-cyclically (80% of cases) experience CPP. High levels of anxiety and depression have been described in patients with endometriosis related to CPP; however, this has not been evaluated in endometriosis women with different types of CPP. Therefore, the research question of this study was whether there is a difference in the emotional dysregulation due to the type of pain experienced by women with endometriosis? Methods: This work was performed in the National Institute of Perinatology (INPer) in Mexico City from January 2019 to March 2020 and aimed to determine if there are differences in emotional dysregulation in patients with cyclical and non-cyclical CPP. 49 women from 18 to 52 years-old diagnosed with endometriosis presenting cyclical and non-cyclical CPP answered several batteries made up of Mini-Mental State Examination, Visual Analog Scale, Beck's Depression Inventory, State Trait-Anxiety Inventory, and Generalized Anxiety Inventory. Mann–Whitney U and Student’s t-test for independent samples to compare the difference between groups was used. Relative risk estimation was performed to determine the association between non-cyclical and cyclical CPP with probability of presenting emotional dysregulation. Results: We observed that patients with non-cyclical CPP exhibited higher levels of depression and anxiety (trait-state and generalized anxiety) than patients with cyclical pain, p < 0.05 was considered significant. No differences were observed in pain intensity, but there was a higher probability of developing emotional dysregulation (anxiety or depression) in patients with non-cyclical CPP. No differences were observed in cognitive impairment. Conclusions: Our data suggest that patients with non-cyclical (persistent) CPP present a higher emotional dysregulation than those with cyclical pain.

Pregnancy in women living with human immunodeficiency virus (WLWH) represents an important challenge for maternal-fetal health. Besides, they can also present anxiety (Anx) and depression (Dep). Imbalances in serotonin (5-HT), dehydroepiandrosterone sulfate (DHEA-S), and cortisol (CORT) levels can contribute to Anx and Dep manifestations. Currently, there is not enough data about the neuroendocrine and neurochemical changes in pregnant WLWH with affective disorders. This study aimed to characterize 5-HT, DHEA-S, and CORT plasma levels in Mexican pregnant WLWH presenting Anx/Dep. Forty-two adult pregnant women were recruited during the third trimester of gestation at the National Institute of Perinatology in Mexico during 2019–2022. These patients were divided into three groups: (1) pregnant WLWH with Anx/Dep (n = 16), (2) pregnant without HIV but with Anx/Dep (n = 12), and (3) healthy pregnant women without Anx/Dep (n = 14). WLWH presented a marked reduction in 5-HT (41.33 ± 39.37 ng/dL) compared to non-infected pregnant women with Anx/Dep (220.2 ± 151.8 ng/dL) and the healthy group (370.0 ± 145.3 ng/dL). Anx/Dep infected and uninfected pregnant women showed a significant reduction in DHEA-S levels (86.58 ± 30.59 and 76.9 ± 36.7 µg/dL, respectively) compared to healthy subjects (149.7 ± 44.6 µg/dL). Anx and Dep symptoms were inversely correlated with 5-HT and DHEA-S levels. No significant differences were observed in CORT levels among the three groups (p = 0.094). Our results suggest the presence of a disbalance in 5-HT and DHEA-S levels in pregnant WLWH with affective symptoms.

Introduction: In Mexico, the National Survey of Psychiatric Epidemiology (ENEP) in 2012, refers that 9.2% of the general population suffered an affective disorder at some point in life, the highest frequency was observed in women (10.4%) while in men (5.4%). In pregnancy, the prevalence of depression is higher compared to the general population (22 to 37%). Marital satisfaction during pregnancy may experience fluctuations due to such psycho-emotional conditions, at the same time, the physical and hormonal changes of the woman, as well as the alteration in the dynamics of the relationship with the partner suppose factors that violate the well-being and marital satisfaction, putting at risk the stability of the couple relationship. Methods Cross-sectional, observational, descriptive study that included pregnant women with HIV who presented traits of anxiety and depression. A psychometric battery was applied consisting of: State-Trait Anxiety Inventory (STAI), Beck Depression Inventory II (BDI-II), and the Marital Satisfaction Scale (MSS Spanish version). Results 60 patients were recruited and divided into 2 groups (HIV + and HIV-). Anxiety and depression levels were similar in both groups (p > 0.05) but HIV + patients showed lower marital satisfaction (p = 0.051) related to the increase of depressive traits (ρ= -0.33, p < 0.001). Conclusions HIV status during pregnancy may increase the possibility of presenting trait/state anxiety traits and depression, a condition related to major marital dissatisfaction. Clinical Trial Number: 2017-3-128.

Women with endometriosis experience chronic cyclic pelvic pain (CCPP) or chronic persistent pelvic pain (CPPP), both of which may be incapacitating even after treatment. Emotional dysregulation in endometriosis impedes patient recovery. This study evaluated the relationships among emotional state, pain perception, and inflammatory biomarkers (IL-1β, IL-6, and TNF-α) in women with endometriosis presenting with CCPP or CPPP. An exploratory, observational, descriptive, cross-sectional, comparative with repeated sampling study was conducted with 52 women diagnosed with endometriosis and experiencing either CPPP or CCPP. Participants completed a psychometric battery including the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI-II), Goldberg General Health Questionnaire (GHQ-30), Hospital Anxiety and Depression Scale (HADS), and Mini-Mental State Examination (MMSE). Pain perception was assessed using the Wong–Baker Pain Rating Scale (FACES). Saliva samples were collected at baseline, during stressor and recovery phases, and concentrations of IL-1β, IL-6, and TNF-α were determined by ELISA. Fifty-two women with endometriosis were included (CPPP: n = 33; CCPP: n = 19). No significant between group differences were observed in emotional state (HADS: p = 0.682; BDI: p = 0.842), anxiety (STAI-State: p = 0.086; STAI-Trait: p = 0.615), general distress (GHQ-30: p = 0.730), or pain intensity (FACES: p = 0.705). The prevalence of depressive symptoms did not differ between groups (CPPP: 69.7% vs. CCPP: 73.7%; χ² = 0.093, p = 0.760). Salivary cytokine levels (IL-1β, IL-6, TNF-α) were comparable between groups across all measurement conditions. Spearman correlations revealed uncorrected significance between TNF-α and emotional distress: basal TNF-α correlated inversely with HADS (ρ = −0.292, p = 0.031) and BDI (ρ = −0.278, p = 0.041); TNF-α under stress correlated with HADS (ρ = −0.329, p = 0.014) and GHQ-30 (ρ = −0.271, p = 0.046); and TNF-α during recovery correlated with GHQ-30 (ρ = −0.363, p = 0.006). These findings indicate that CPPP and CCPP were not associated with statistically significant differences in emotional states or salivary cytokine profiles at the group level. Exploratory pos hoc analyses suggested that pain pattern may moderate the association between TNF-α and psychological burden, particularly in the CCPP subgroup; however, these findings require confirmation in larger studies with prespecified analyses. Exploratory analyses suggested patterns between salivary inflammation and psychological burden; however, these findings should be interpreted cautiously because of the small subgroup size, multiple comparisons, and lack of a matched healthy control group.

Antenatal anxiety and depression are common and frequently comorbid, affecting maternal and offspring outcomes; however, their underlying biological correlates remain incompletely understood. This cross-sectional study examined whether peripheral levels of brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) were associated with anxiety and depressive symptoms during late pregnancy. A total of 148 women with uncomplicated second and third-trimester pregnancies was assessed using the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale. Serum BDNF levels were quantified by ELISA, whereas VEGF and EGF were measured using a multiplex bead-based immunoassay. Based on scale scores, participants were classified as controls, women with anxiety without depressive symptoms, or women with anxiety and depressive symptoms. In the between-group comparisons, women with clinically significant anxiety exhibited higher BDNF and EGF levels than controls, whereas differences in VEGF levels did not reach statistical significance. Regression analyses indicated that anxiety severity was positively associated with BDNF, VEGF, and EGF levels, whereas depressive symptom severity was negatively associated with BDNF levels. These findings suggest distinct associations of antenatal anxiety and depressive symptoms with circulating growth factors, particularly BDNF, and warrant further investigation of vascular–immune–neurotrophic pathways potentially involved in perinatal mental health.

Antenatal anxiety and depression frequently co-occur, negatively affecting maternal and offspring outcomes, yet their biological correlates remain insufficiently characterized. This cross-sectional study examined associations between anxiety and depressive symptoms and serum concentrations of brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF), proteins implicated in pregnancy-related vascular adaptations whose dysregulation has been associated with placental dysfunction and negative perinatal outcomes. A total of 148 women with uncomplicated second- and third-trimester pregnancies were assessed using the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale. Serum BDNF levels were quantified by enzyme-linked immunosorbent assay, whereas VEGF and EGF were measured using a multiplex bead-based immunoassay during late pregnancy. Based on scale scores, participants were classified as controls, women with anxiety without depressive symptoms, or women with anxiety and depressive symptoms. In the between-group comparisons, women with clinically significant anxiety exhibited higher BDNF and EGF levels than controls. Regression analyses indicated that anxiety severity was positively associated with BDNF, VEGF, and EGF levels (all p < 0.05), whereas depressive symptom severity was negatively associated with BDNF levels (p < 0.05). These findings suggest distinct associations of antenatal anxiety and depressive symptoms with circulating growth factors, particularly BDNF, and warrant further investigation of vascular–immune–neurotrophic pathways potentially involved in perinatal mental health.