{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:27:08Z","timestamp":1787498828450,"version":"build-2736575974"},"reference-count":57,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T00:00:00Z","timestamp":1633824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Endometriosis is a chronic gynecological disease that impacts more than 176 million women worldwide, having a strong impact on psychological morbidity. This study aimed to evaluate the contribution of psychological morbidity, in women with endometriosis, taking into consideration the duration of the couple\u2019s relationship and the duration of the disease and also examined whether women\u2019s sexual satisfaction had an impact on their psychological morbidity (actor effect) and on their sexual partners\u2019 psychological morbidity (partner effect) and vice versa. Participants were 105 women and their partners, who answered the Hospital Anxiety and Depression Scale (HADS); Couple Satisfaction Index (CSI-4) and the Global Measure of Sexual Satisfaction (GMSEX). The results revealed a direct effect between the perception of symptom severity, marital satisfaction, and women\u2019s psychological morbidity. Sexual activity and the presence of infertility had an indirect effect on the relationship between sexual satisfaction, diagnosis duration, and psychological morbidity, respectively. Finally, women\u2019s sexual satisfaction had a direct effect on their own and their partner\u2019s marital satisfaction that predicted less psychological morbidity, in both. Thus, a multidisciplinary intervention focused on the couple\u2019s sexual and marital relationship is needed to promote psychological well-being in this population.<\/jats:p>","DOI":"10.3390\/ijerph182010598","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T21:23:25Z","timestamp":1633901005000},"page":"10598","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Psychological Morbidity in Endometriosis: A Couple\u2019s Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7987-2562","authenticated-orcid":false,"given":"Maria Gra\u00e7a","family":"Pereira","sequence":"first","affiliation":[{"name":"Psychology Research Center (CIPsi), School of Psychology, University of Minho, 4710-057 Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2809-7708","authenticated-orcid":false,"given":"In\u00eas","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Minho, 4710-057 Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5416-7629","authenticated-orcid":false,"given":"H\u00e9lder","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Centro Materno-Infantil do Norte, Centro Hospitalar Universit\u00e1rio do Porto, 4099-001 Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7235-4295","authenticated-orcid":false,"given":"Filipa","family":"Os\u00f3rio","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Hospital da Luz, 1649-028 Lisboa, Portugal"},{"name":"Departament of Obstetrics, Gynecology and Reproduction Medicine, Hospital Santa Maria, 1649-028 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-2911","authenticated-orcid":false,"given":"Cristina","family":"Nogueira-Silva","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute, School of Medicine, University of Minho, 4710-057 Braga, Portugal"},{"name":"ICVS\/3B\u2019s\u2014PT Government Associate Laboratory, 4710-057 Braga, Portugal"},{"name":"Department of Obstetrics and Gynecology, Hospital de Braga, 4710-243 Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-9087","authenticated-orcid":false,"given":"Ana C.","family":"Almeida","sequence":"additional","affiliation":[{"name":"Psychology Research Center (CIPsi), School of Psychology, University of Minho, 4710-057 Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.11606\/issn.2176-7262.v48i5p478-490","article-title":"Disfun\u00e7\u00e3o sexual em endometriosis: Uma revis\u00e3o sistem\u00e1tica. 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