O-30 A cross-sectional survey of stigma, anxiety, and depression in women with endometriosis and/or uterine fibroids in Barbados

Methods: An online cross-sectional population-based study was conducted in Barbados from March to May 2025. Barbadian women, self-reporting a diagnosis of endometriosis and/or uterine fibroids by a qualified healthcare professional were included. Data were analyzed: mean anticipated stigma and mean internalized stigma scores were calculated. Logistic regression assessed the relationship between mean stigma scores and severe depression (Patient Health Questionnaire-9 (PHQ9): ≥20) as well as mean stigma scores and severe anxiety (Generalized Anxiety Disorder-7 (GAD7): ≥15). This study received ethical approval from The University of the West Indies (IRB #: CREC-CH.00305/05/2024) and George Mason University (IRB #:2206605-1).

Results: Three hundred and fifty three (n=353) Barbadian women self-reporting a diagnosis of endometriosis and/or uterine fibroids were included. Most had uterine fibroids only (n=217; 61.5%), followed by a dual diagnosis of endometriosis and uterine fibroids (n=71;20.1%) and then those with endometriosis only (n=65; 18.4%). Mean stigma scores were 1.77 (anticipated) and 2.10 (internalized) on a 5-point scale (1 being the lowest and 5 being the highest). Severe depression was reported by 7.9% and 15.6% reported severe anxiety. In adjusted models, stigma was associated with an increased likelihood of severe depression (anticipated (aOR=2.57; 95% CI:1.67-4.06); internalized (aOR =6.74; 95% CI: 3.53–14.35)) and severe anxiety (anticipated (aOR=1.87; 95% CI: 1.29–2.54); internalized (aOR=1.69; 95% CI: 1.14–2.52)).

Conclusion: Barbadian women with endometriosis and/ or uterine fibroids experience anticipated and internalized stigma which are significantly associated with severe depression and severe anxiety. Culturally appropriate multicomponent stigma reducing interventions are warranted to improve mental health outcomes for this population.