The psychosocial transition associated with spontaneous 46,XX primary ovarian insufficiency: illness uncertainty, stigma, goal flexibility, and purpose in life as factors in emotional health

Objective: To examine factors associated with emotional well-being in women with spontaneous primary ovarian insufficiency. Design: Cross-sectional and case-control study. Setting: Clinical research center, national U.S. health research facility. Patient(s): Women diagnosed with spontaneous 46,XX primary ovarian insufficiency (n = 100) at a mean age of 32.4 years and healthy control women of similar age (n = 60). Intervention(s): Administration of validated self-reporting instruments. Main Outcome Measure(s): Illness uncertainty, stigma, goal disengagement/re-engagement, purpose in life, Positive and Negative Affect Schedule, Center of Epidemiologic Studies Depression Scale, State-Trait Anxiety Inventory. Result(s): Compared with controls, women with spontaneous primary ovarian insufficiency scored adversely on all measures of affect. Illness uncertainty and purpose in life were significant independent factors associated with anxiety (R-2 = 0.47), stigma and purpose in life were the significant independent factors associated with depression (R-2 = 0.51), and goal re-engagement and purpose in life were significantly and independently associated with positive affect (R-2 = 0.43). Conclusion(s): This evidence supports the need for prospective studies. Our findings are consistent with the hypothesis that clinicians could improve the emotional well-being of their patients with primary ovarian insufficiency by [1] informing them better about their condition, [2] helping them to feel less stigmatized by the disorder, and [3] assisting them in developing alternative goals with regard to family planning as well as other goals. (Fertil Steril (R) 2010; 93: 2321-9. (C)2010 by American Society for Reproductive Medicine.)