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Hsu TW, Kao YC, Tsai SJ, Bai YM, Su TP, Chen TJ, Liang CS, Chen MH. Suicide Attempts After a Diagnosis of Polycystic Ovary Syndrome : A Cohort Study. Ann Intern Med 2024; 177:335-342. [PMID: 38315996 DOI: 10.7326/m23-2240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Limited evidence exists about suicide risk in persons with polycystic ovary syndrome (PCOS). OBJECTIVE To assess suicide risk in persons with PCOS, accounting for psychiatric comorbid conditions and age group. DESIGN Cohort study. SETTING Data from the Taiwanese nationwide database from 1997 to 2012. PATIENTS A cohort of 18 960 patients diagnosed with PCOS, each matched with control participants in a 1:10 ratio on the basis of age, psychiatric comorbid conditions, urbanization level, and income. Suicide attempts were evaluated using Cox regression models. MEASUREMENTS Suicide risk with hazard ratios (HRs). RESULTS Participants with PCOS had a notable 8.47-fold increase in risk for suicide attempt compared with the control group (HR, 8.47 [95% CI, 7.54 to 9.51]), after adjustment for demographic characteristics, psychiatric comorbid conditions, Charlson Comorbidity Index scores, and frequency of all-cause clinical visits. The elevated risk was evident across the adolescent (HR, 5.38 [CI, 3.93 to 7.37]), young adult (<40 years; HR, 9.15 [CI, 8.03 to 10.42]), and older adult (HR, 3.75 [CI, 2.23 to 6.28]) groups. Sensitivity analyses involving the exclusion of data from the first year or the first 3 years of observation yielded consistent results. LIMITATION Potential underestimation of PCOS and mental disorder prevalence due to use of administrative claims data; lack of clinical data, such as body mass index and depressive symptoms; and no assessment of a confounding effect of valproic acid exposure. CONCLUSION This study underscores the heightened risk for suicide attempt that persons with PCOS face, even after adjustment for demographics, psychiatric comorbid conditions, physical conditions, and all-cause clinical visits. This suggests the importance of routine monitoring of mental health and suicide risk in persons diagnosed with PCOS. PRIMARY FUNDING SOURCE Taipei Veterans General Hospital, Yen Tjing Ling Medical Foundation, and Ministry of Science and Technology of Taiwan.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, E-DA Dachang Hospital, and Department of Psychiatry, E-DA Hospital, Kaohsiung, Taiwan (T.-W.H.)
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, and Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Y.-C.K., C.-S.L.)
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (S.-J.T., Y.-M.B., M.-H.C.)
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (S.-J.T., Y.-M.B., M.-H.C.)
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University; and Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan (T.-P.S.)
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, and Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan, and Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan (T.-J.C.)
| | - Chih-Sung Liang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, and Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan (Y.-C.K., C.-S.L.)
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, and Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (S.-J.T., Y.-M.B., M.-H.C.)
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Nasiri-Amiri F, Faramarzi M, Omidvar S, Alizadeh-Navaei R. Depression and anxiety in adolescents and young women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Adolesc Med Health 2023:ijamh-2022-0065. [PMID: 37158791 DOI: 10.1515/ijamh-2022-0065] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To evaluate the depression and anxiety symptoms, or both in adolescents and young women with polycystic ovary syndrome (PCOS) to those without PCOS. CONTENTS A comprehensive electronic search was conducted to identify observational studies on PCOS patients (January 1991-December 2020). The population study included adolescents and young women (14-29 years of age) in two groups of cases (with PCOS) and controls (without PCOS) who were diagnosed with PCOS using the Rotterdam or National Institutes of Health criteria (NIH). Symptoms of depression, anxiety, or both, reported separately, were of interest. Mean (SD) of depression or anxiety symptoms, or both, as measured by a quantitatively validated scale for both the case and control groups. All eligible studies were quality assessed using the Newcastle-Ottawa Scale (NOS) tool. The initial database search resulted in the discovery of 1,582 papers, of which 806 were selected after screening the titles and abstracts and removing duplicates. A total of 49 papers were found to be suitable for full-text reading. This meta-analysis included ten studies comprising 941 adolescent/young women (391 with PCOS and 550 without PCOS). The standard mean difference (SMD) and its corresponding confidence interval (CI) at 95 % were used to compare depression or anxiety symptoms, or both, between two groups. SUMMARY AND OUTLOOK The results, which included 192 cases, demonstrated that adolescents/young women with PCOS had significantly more depressive symptoms than those without PCOS (n=360) (SMD 0.72; 95 % CI, 0.09-1.34; Z=2.25, p=0.025; Heterogeneity: I2=89.7 %; p=0.000). Also, the results which included 299 cases demonstrated that adolescents/young women with PCOS had significantly more anxiety symptoms than those without PCOS (n=421) (SMD 0.59; 95 % CI, 0.13-1.05; Z=2.51, p=0.012; Heterogeneity: I2=86.1 %; p=0.000). This meta-analysis demonstrates that adolescent/young women with PCOS have significantly more depression or anxiety symptoms than those without PCOS.
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Affiliation(s)
- Fatemeh Nasiri-Amiri
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I. R. Iran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Reproductive Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Midwifery School of Nursing & Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Reza Alizadeh-Navaei
- Biomedical Sciences, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Schweisberger CL, Hornberger L, Barral R, Burke C, Paprocki E, Sherman A, Brink HV, Burgert TS. Gender diversity in adolescents with polycystic ovary syndrome. J Pediatr Endocrinol Metab 2022; 35:1422-1428. [PMID: 36198004 PMCID: PMC10274191 DOI: 10.1515/jpem-2022-0249] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/05/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective of our study was to describe the prevalence of gender diverse (GD) youth among adolescents with polycystic ovary syndrome (PCOS). METHODS We conducted a retrospective chart review on patients who met NIH criteria for PCOS in our Multidisciplinary Adolescent PCOS Program (MAPP). We compared those with PCOS to MAPP patients who did not meet PCOS criteria as well as to non-PCOS patients from the Adolescent Specialty Clinic (ASC). Variables analyzed included gender identity, androgen levels, hirsutism scores, and mood disorders. We used chi-square, Fisher's exact, t-tests, and Wilcoxon rank sum tests to compare groups. Gender identities self-reported as male, fluid/both or nonbinary were pooled into the GD category. RESULTS Within the MAPP, 7.6% (n=12) of PCOS youth self-identified as GD compared to 1.8% (n=3) of non PCOS youth (p=0.01, chi-square). When compared to non-PCOS GD adolescents from ASC (4.4%; n=3), the difference to PCOS youth was no longer significant (p=0.56). Among MAPP patients, gender diversity was associated with higher hirsutism scores (p<0.01), but not higher androgen levels. In PCOS, depression/anxiety was higher in GD vs cisgender youth (100% vs. 37.6%, p<0.01 and 77.8% vs. 35.8%, p=0.03 respectively). CONCLUSIONS Gender diversity was observed more commonly in those meeting PCOS criteria. PCOS GD youth were more hirsute and reported more depression/anxiety. Routine screening for differences in gender identity in comprehensive adolescent PCOS programs could benefit these patients, as alternate treatment approaches may be desired to support a transmasculine identity.
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Affiliation(s)
| | - Laurie Hornberger
- Division of Adolescent Medicine, Children’s Mercy Hospital, Kansas City, MO, USA
| | - Romina Barral
- Division of Adolescent Medicine, Children’s Mercy Hospital, Kansas City, MO, USA; University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA; and University of Kansas Medical Center, Kansas City, KS, USA
| | - Charles Burke
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA
| | - Emily Paprocki
- Division of Endocrinology, Children’s Mercy Hospital, Kansas City, MO, USA; and University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Ashley Sherman
- Division of Health Services and Outcomes Research, Children’s Mercy Hospital, Kansas City, MO, USA
| | - Heidi Vanden Brink
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA; and Division of Endocrinology, Children’s Mercy Hospital, Kansas City, MO, USA
| | - Tania S. Burgert
- Division of Endocrinology, Children’s Mercy Hospital and Clinics, 3101 Broadway Blvd, Kansas City, MO 64111, USA
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Dybciak P, Humeniuk E, Raczkiewicz D, Krakowiak J, Wdowiak A, Bojar I. Anxiety and Depression in Women with Polycystic Ovary Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070942. [PMID: 35888661 PMCID: PMC9319705 DOI: 10.3390/medicina58070942] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Mental health disorders are often the consequence of hormonal disorders such as those accompanying polycystic ovary syndrome (PCOS), where changes in appearance and having to deal with a number of other problems occur due to this illness. The objective of this study was to determine the prevalence and severity of anxiety and depression symptoms, the level of ego-resiliency, and the ways that women with PCOS cope with stress compared to healthy women in order to determine the influence of socio-demographic characteristics in relation to levels of anxiety and depression with ego-resiliency and stress-coping methods. Materials and Methods: The study was conducted in Poland in 2021 and included 230 women with PCOS and 199 healthy controls aged 20-40 years old. The hospital anxiety and depression scale (HADs), ego-resiliency scale, as well as the MINI-COPE inventory were used. Results: The women with PCOS had higher levels of anxiety and depression and poorer ego-resiliency in comparison to the healthy women. The women with PCOS used passive stress-coping strategies significantly more commonly than the healthy women. Living in rural areas, having a lower level of education and being childless increased anxiety levels. Similarly, being over 30, living in a rural area, having a lower level of education, being childless, and being obese increased depression levels in the women with PCOS. A low level of ego-resiliency and passive stress-coping strategies are predictors of high levels of anxiety and depression in women with PCOS. Conclusions: Women with PCOS should be checked for anxiety and depression. They should also be checked to see whether they have the resources to cope with chronic stress in order to optimize therapeutic interventions.
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Affiliation(s)
- Paweł Dybciak
- Plastic Surgery and Advanced Laser & Skincare Aesthetics, “The Clinic” Warsaw, Krochmalna 59A Street, 00-864 Warsaw, Poland;
| | - Ewa Humeniuk
- Chair and Department of Psychology, Faculty of Medical Sciences, Medical University of Lublin, Chodzki 7 Street, 20-400 Lublin, Poland;
| | - Dorota Raczkiewicz
- Department of Medical Statistics, School of Public Health, Centre of Postgraduate Medical Education, Kleczewska 61/63 Street, 01-826 Warsaw, Poland;
| | - Jan Krakowiak
- Department of Social Medicine, Medical University of Lodz, Żeligowskiego 7/9 Street, 90-752 Lodz, Poland;
| | - Artur Wdowiak
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, Staszica 4-6 Street, 20-081 Lublin, Poland;
| | - Iwona Bojar
- Department of Women’s Health, Institute of Rural Health in Lublin, Jaczewskiego 2 Street, 20-090 Lublin, Poland
- Correspondence: ; Tel.: +48-606722112
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Donbaloğlu Z, Tuhan H, Çoban ÖG, Kızılay DÖ, İsmailoğlu E, Önder A, Acar S, Bedel A, Çetiner EB, Singin B, Erdem H, Parlak M. Hyperandrogenism correlates with psychological symptoms in adolescents with polycystic ovary syndrome. Clin Pediatr Endocrinol 2022; 31:68-76. [PMID: 35431449 PMCID: PMC8981047 DOI: 10.1297/cpe.2022-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/26/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to analyze the depressive and anxiety states of adolescent girls with
polycystic ovary syndrome (PCOS). This was a cross-sectional, multicenter, case–control
study. A total of 100 participants (PCOS group, 51; control group, 49) aged 13–18 yr were
included in the study. Body mass index was higher in patients with PCOS (P = 0.002). In
the PCOS group, 28.5% of the patients had moderate-to-severe depressive symptoms, whereas
the incidence was lower in controls (8.3%, P = 0.021). The State-Trait Anxiety Inventory
(STAI)-State, STAI-Trait, and physical, psychosocial, and total Pediatric Quality of Life
Inventory PedsQL scores were higher in the PCOS group, suggesting that anxiety was more
common and the quality of life was worse in patients with PCOS than in healthy
participants (P = 0.01, P = 0.03, P = 0.02, P = 0.046, and P = 0.047, respectively). The
serum free testosterone (fT) levels were positively correlated with the depression and
anxiety scores and negatively correlated with the psychosocial PedsQL scores. In
conclusion, adolescent girls diagnosed with PCOS demonstrated higher depressive and
anxiety symptoms and lower psychosocial quality of life scores than their healthy
counterparts. A relationship was found between the fT level and all psychological
measures.
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Affiliation(s)
- Zeynep Donbaloğlu
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Hale Tuhan
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry, Akdeniz University Hospital, Antalya, Turkey
| | - Deniz Özalp Kızılay
- Department of Pediatric Endocrinology, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Eren İsmailoğlu
- Department of Radiology, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Akdeniz University Hospital, Antalya, Turkey
| | - Sezer Acar
- Department of Pediatric Endocrinology, Behçet Uz Children Hospital, İzmir, Turkey
| | - Aynur Bedel
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Ebru Barsal Çetiner
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Berna Singin
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Harun Erdem
- Department of Child and Adolescent Psychiatry, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Mesut Parlak
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
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Zehravi M, Maqbool M, Ara I. Depression and anxiety in women with polycystic ovarian syndrome: a literature survey. Int J Adolesc Med Health 2021; 33:367-373. [PMID: 34420269 DOI: 10.1515/ijamh-2021-0092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/14/2021] [Indexed: 11/15/2022]
Abstract
Polycystic ovarian syndrome (PCOS) is the most frequent endocrine disorder among women of reproductive age. Some of the indications and symptoms of PCOS include amenorrhoea, hirsutism, infertility, obesity, acne vulgaris and androgenic alopecia. PCOS is a crippling condition that affects a woman's identity, mental health and overall quality of life (QOL). In persons with PCOS, anxiety and sadness are assumed to be multifactorial. According to some specialists, physical symptoms like acne, hirsutism and obesity have been linked to psychiatric morbidities. Many aspects of it remain unknown, including its cause, progression throughout life, symptom spectrum and level of morbidity. PCOS is a complex disease that has an impact on many aspects of a person's health, including their mental health. Anxiety and depression are three times as common in PCOS patients as in non-PCOS people. Anxiety and depression symptoms are also more common and more intense in those with PCOS. There isn't enough research on the prevalence of anxiety and depression in patients with PCOS. It's unclear what causes persons with PCOS to be more anxious and depressed. It could be the result of PCOS symptoms, hormonal changes, or a combination of factors that are currently unclear. Our review article will help to highlight the most recent research on anxiety and depression in PCOS women.
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Affiliation(s)
- Mehrukh Zehravi
- Department of Clinical Pharmacy Girls Section, Prince Sattam Bin Abdul Aziz University, Alkharj, Saudia Arabia
| | - Mudasir Maqbool
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Irfat Ara
- Regional Research Institute of Unani Medicine, Srinagar, Jammu and Kashmir, India
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Chen F, Chen Z, Chen M, Chen G, Huang Q, Yang X, Yin H, Chen L, Zhang W, Lin H, Ou M, Wang L, Chen Y, Lin C, Xu W, Yin G. Reduced stress-associated FKBP5 DNA methylation together with gut microbiota dysbiosis is linked with the progression of obese PCOS patients. NPJ Biofilms Microbiomes 2021; 7:60. [PMID: 34267209 PMCID: PMC8282850 DOI: 10.1038/s41522-021-00231-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/23/2021] [Indexed: 02/05/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disease in females that is characterized by hyperandrogenemia, chronic anovulation, and polycystic ovaries. However, the exact etiology and pathogenesis of PCOS are still unknown. The aim of this study was to clarify the bacterial, stress status, and metabolic differences in the gut microbiomes of healthy individuals and patients with high body mass index (BMI) PCOS (PCOS-HB) and normal BMI PCOS (PCOS-LB), respectively. Here, we compared the gut microbiota characteristics of PCOS-HB, PCOS-LB, and healthy controls by 16S rRNA gene sequencing, FK506-binding protein 5 (FKBP5) DNA methylation and plasma metabolite determination. Clinical parameter comparisons indicated that PCOS patients had higher concentrations of total testosterone, androstenedione, dehydroepiandrosterone sulfate, luteinizing hormone, and HOMA-IR while lower FKBP5 DNA methylation. Significant differences in bacterial diversity and community were observed between the PCOS and healthy groups but not between the PCOS-HB and PCOS-LB groups. Bacterial species number was negatively correlated with insulin concentrations (both under fasting status and 120 min after glucose load) and HOMA-IR but positively related to FKBP5 DNA methylation. Compared to the healthy group, both PCOS groups had significant changes in bacterial genera, including Prevotella_9, Dorea, Maihella, and Slackia, and plasma metabolites, including estrone sulfate, lysophosphatidyl choline 18:2, and phosphatidylcholine (22:6e/19:1). The correlation network revealed the complicated interaction of the clinical index, bacterial genus, stress indices, and metabolites. Our work links the stress responses and gut microbiota characteristics of PCOS disease, which might afford perspectives to understand the progression of PCOS.
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Affiliation(s)
- Fu Chen
- Department of Clinical Nutrition, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Zhangran Chen
- Institute for Microbial Ecology, School of Medicine, Xiamen University, Xiamen, Fujian Province, China
| | - Minjie Chen
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
- Laboratory of Molecular Cardiology and Laboratory of Molecular Imaging, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Guishan Chen
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Qingxia Huang
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Xiaoping Yang
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Huihuang Yin
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
- Laboratory of Molecular Cardiology and Laboratory of Molecular Imaging, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Lan Chen
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Weichun Zhang
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Hong Lin
- Department of Reproductive Center, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Miaoqiong Ou
- Department of Clinical Nutrition, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Luanhong Wang
- Department of Gynecological tumor, Tumor Hospital Affiliated to Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yongsong Chen
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Chujia Lin
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Wencan Xu
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Guoshu Yin
- Department of Endocrinology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.
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Naumova I, Castelo-Branco C, Casals G. Psychological Issues and Sexual Function in Women with Different Infertility Causes: Focus on Polycystic Ovary Syndrome. Reprod Sci 2021; 28:2830-2838. [PMID: 33763818 DOI: 10.1007/s43032-021-00546-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/09/2021] [Indexed: 12/30/2022]
Abstract
The objectives of this study are to assess the prevalence of psychological complaints and changes in sexual function in infertile PCOS women compared with patients with other infertility causes (tubal and male infertility factors) and to identify the predisposing factors. An observational study with three cohorts of infertile women was designed including 37 PCOS patients, 36 women with tubal factor, and 31 women with male factor. Clinical history and physical examination were carried out in all patients. All subjects completed the Hamilton Anxiety Rating Scale, the Beck Depression Inventory, and the Female Sexual Function Index questionnaires. Women with infertility due to PCOS showed a significantly higher prevalence of depressive (48.6 vs 19.4 and 12.9%, p < 0.01) and anxiety symptoms (21.6 vs 5.6 and 3.2%, p = 0.041) than respondents of reference groups. Sexual function in PCOS subjects was impaired in the areas orgasm and satisfaction (p < 0.01 for both) compared to patients of reference groups. Clinical, biochemical hyperandrogenism, and overweight were associated with a higher incidence of depressive and anxiety symptoms in the infertile PCOS group (p < 0.01 for all). Besides, the severity of anxiety symptoms was associated with the number of medically assisted reproduction attempts (p = 0.014). Weight gain and age (p = 0.04 and p = 0.047) were associated with impaired sexual functioning. The relation between reduced sexuality and depressive/anxiety symptoms was found (p = 0.038 and p = 0.012, respectively). Infertile PCOS patients showed the highest prevalence of psychological complaints and some impairment in their sexual functioning. Mental health and sexual functioning need to be part of the routine clinical screening of every PCOS patient. The study was registered at clinicaltrials.gov (identifier: NCT03306459) https://clinicaltrials.gov/ct2/show/NCT03306459?cond=PCOS&cntry=ES&city=Barcelona&draw=2&rank=3.
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Affiliation(s)
- Iuliia Naumova
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain
- Department of Obstetrics and Gynecology, Faculty of General Medicine, Saratov State Medical University n.a. V.I. Razumovsky, Saratov, Russian Federation
| | - Camil Castelo-Branco
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain.
| | - Gemma Casals
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Spain
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Gnawali A, Patel V, Cuello-Ramírez A, Al Kaabi AS, Noor A, Rashid MY, Henin S, Mostafa JA. Why are Women With Polycystic Ovary Syndrome at Increased Risk of Depression? Exploring the Etiological Maze. Cureus 2021; 13:e13489. [PMID: 33777576 PMCID: PMC7990040 DOI: 10.7759/cureus.13489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex and common multisystemic disorder. Women with PCOS have up to eight times higher prevalence of depression than control groups. This paper aims to explore the underlying risk factors for developing depression in this high-risk group. Studies indicate an interplay of multiple mechanisms that place women with PCOS at an increased risk for depression. The pathophysiology thought to play a role includes disturbances in the endocrine axes and changes to the metabolic pathway. The risk of depression is independently linked to insulin resistance and obesity in this population. However, rates of depression were still higher than control groups when accounting for these variables, demonstrating that they are not the only mechanism causing depression. The clinical manifestations of hyperandrogenism and menstrual abnormalities may compound negative views and lower self-esteem and negatively impact mood. Many of these women also struggle with infertility, and due to the added external pressures like societal beliefs and culture, they may be further negatively impacted and worsen their depressive symptoms. The prevalence of depression in women with PCOS is high; thus, this paper highlights the essential understanding of the underlying mechanisms at play. This is to better aid in addressing the fundamental cause of depression in this high-risk group effectively.
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Affiliation(s)
- Anupa Gnawali
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Viral Patel
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Anoud S Al Kaabi
- Neonatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Asfa Noor
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammed Y Rashid
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shereen Henin
- Internal Medicine, Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jihan A Mostafa
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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10
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Khafagy G, El Sayed I, Abbas S, Soliman S. Perceived Stress Scale Among Adolescents with Polycystic Ovary Syndrome. Int J Womens Health 2020; 12:1253-1258. [PMID: 33402850 PMCID: PMC7778675 DOI: 10.2147/ijwh.s279245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/26/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Polycystic ovary syndrome (PCOS) is a common disorder that affects women during their reproductive age. Previous studies have suggested that PCOS may be linked to some mental disorders. Aim The study aimed to estimate the perceived stress among adolescents with PCOS and investigate the relationship between PCOS symptoms and perceived stress scale (PSS) in adolescents. Methods This was a case control study with 72 participants (between 11 and 19 years); 36 adolescents with PCOS and 36 matched controls were recruited from family medicine and gynecological outpatient clinics at Cairo University hospitals. They participated in a structured interview using a pre-designed questionnaire. Full general examination was conducted, including anthropometric measures, acne staging, and hirsutism staging using the Ferriman–Gallwey score. We assessed the severity of stress over the previous month of interview using the 10-item perceived stress scale (PSS-10). Results There was a statistically significant difference in PSS scores among adolescents with and without PCOS; most cases with severe PSS scores were found to have PCOS. The mean score of PSS was higher in PCOS adolescents (20.416) than in the non-PCOS control group (18.8), but with no statistical significance. There was no significant correlation between the severity of PSS in PCOS adolescents and BMI, WC, acne or hirsutism severity; there was only weak positive correlation between PSS score and DBP (r=0.167). Conclusion PCOS adolescents have higher incidence of severe perceived stress; however, degree of PSS was independent of BMI, WC, acne or hirsutism severity and shows only weak correlations with DBP. Our results urge the need for implementing a holistic approach that should include stress reduction programs to help adolescents get ready for their adult life.
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Affiliation(s)
- Ghada Khafagy
- Family Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Inas El Sayed
- Family Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shimaa Abbas
- Family Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Saeed Soliman
- Family Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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11
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Asdaq SMB, Jomah S, Hasan R, Al-Baroudi D, Alharbi M, Alsubaie S, Buhamad MH, Alyahya B, Al-Yamani MJ. Impact of polycystic ovary syndrome on eating behavior, depression and health related quality of life: A cross-sectional study in Riyadh. Saudi J Biol Sci 2020; 27:3342-3347. [PMID: 33304140 PMCID: PMC7715018 DOI: 10.1016/j.sjbs.2020.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/09/2020] [Accepted: 08/25/2020] [Indexed: 12/02/2022] Open
Abstract
Background & objectives Polycystic ovary syndrome (PCOS) is the most common endocrinal disorder, and the greatest cause of infertility in women. Despite availability of individual data on impact of multiple endocrinal, reproductive and even metabolic factors in PCOS individuals, the data on the co-existence of BED and depression in PCOS patients with its relationship on the quality of life in Saudi Arabian females is not found. Hence this study is aimed to elucidate the implication of PCOS on eating behaviour, induction of depression and general health quality in Saudi Arabian population of Riyadh. Materials and methods This is a cross-sectional study carried out in multiple health facilities of Riyadh from January to March 2019. The study samples (494) were recruited by convenience sampling and administered validated questionnaire by trained research participants. The data obtained was analysed by binary logistic regression using SPSS-IBM 25. Results Of the total 494 women participated in the study, 23.48% (116) were PCOS individuals. The odds of developing abnormal health related quality of (HRQ) in patients with PCOS was significantly (P = 0.000, OR = 3.472) high when compared to non-PCOS participants. The odds of showing high binge eating disorder (BED, P = 0.007, OR = 2.856) and depression (P = 0.000, OR = 2.497) scores in PCOS participants were significantly more than patients who were not having PCOS. Out of the three parameters studied, abnormal health related quality of life possessed a higher influence of PCOS compared to depression and abnormal eating behavior. Interpretation & conclusion In conclusion, the present study shows that women with PCOS are at a significant risk for depressive disorders, disorganized eating behavior and impaired quality of life. Therefore, necessary care and screening is required to minimize the impact of PCOS on already burdened individuals.
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Affiliation(s)
| | - Shahamah Jomah
- College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
| | - Reem Hasan
- College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
| | | | - Mai Alharbi
- College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
| | - Sarah Alsubaie
- College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
| | | | - Bdoor Alyahya
- College of Pharmacy, AlMaarefa University, Riyadh, Saudi Arabia
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12
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Duman M, Durgun Ozan Y. A comparison of physical anxiety levels in adolescent and young women with polycystic ovary syndrome and in other healthy adolescent and young women in a university hospital, Turkey. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-08-2019-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThis study was conducted to investigate the Social Physique Anxiety (SPA) level in adolescent and young women with polycystic ovarian syndrome (PCOS).Design/methodology/approachThis is a descriptive study. It was conducted in Turkey. The study was conducted from January 1, 2017 to December 31, 2017. It was completed with a total of 150 young women – 75 of them had PCOS and 75 of them were healthy. Study data were collected using demographic information form and Social Physique Anxiety Scale (SPAS).FindingsThe study was found that the adolescent and young women with PCOS had higher subscales and total scores for total SPAS at a statistically significant level than healthy adolescent and young women (p < 0.05).Practice implicationThe findings of this study may be used for planning and implementing interventions in health-care practice such as screening and early treatment of SPA of women with PCOS.Originality/valueIt was found that PCOS in adolescent and young women increased the SPA level. In line with these results, health professionals must be particularly aware of the potential psychosocial and health needs of adolescent and young women with PCOS.
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13
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Origins and Impact of Psychological Traits in Polycystic Ovary Syndrome. Med Sci (Basel) 2019; 7:medsci7080086. [PMID: 31387252 PMCID: PMC6723772 DOI: 10.3390/medsci7080086] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/25/2019] [Accepted: 07/31/2019] [Indexed: 12/12/2022] Open
Abstract
Women with polycystic ovary syndrome (PCOS) exhibit compromised psychiatric health. Independent of obesity, women with PCOS are more susceptible to have anxiety and depression diagnoses and other neuropsychiatric disorders. During pregnancy women with PCOS display high circulating androgen levels that may cause prenatal androgen exposure affecting the growing fetus and increasing the risk of mood disorders in offspring. Increasing evidence supports a non-genetic, maternal contribution to the development of PCOS and anxiety disorders in the next generation. Prenatal androgenized rodent models reflecting the anxiety-like phenotype of PCOS in the offspring, found evidence for the altered placenta and androgen receptor function in the amygdala, together with changes in the expression of genes associated with emotional regulation and steroid receptors in the amygdala and hippocampus. These findings defined a previously unknown mechanism that may be critical in understanding how maternal androgen excess can increase the risk of developing anxiety disorders in daughters and partly in sons of PCOS mothers. Maternal obesity is another common feature of PCOS causing an unfavorable intrauterine environment which may contribute to psychiatric problems in the offspring. Whether environmental factors such as prenatal androgen exposure and obesity increase the offspring's susceptibility to develop psychiatric ill-health will be discussed.
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14
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Young CC, Rew L, Monge M. Transition to Self-Management among Adolescents with Polycystic Ovary Syndrome: Parent and Adolescent Perspectives. J Pediatr Nurs 2019; 47:85-91. [PMID: 31079016 PMCID: PMC6642853 DOI: 10.1016/j.pedn.2019.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 04/22/2019] [Accepted: 04/22/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among females. The foundation of PCOS self-management is engaging in healthy lifestyle habits, however, there is limited literature regarding adolescents' transition to PCOS self-management. The purpose of this study, therefore, is to explore parental and adolescent views of the transition to PCOS self-management. DESIGN AND METHODS A qualitative descriptive approach was used through focus groups (N = 4) with adolescents diagnosed with PCOS and their parents. RESULTS A total of seven adolescents and eight parents participated in two focus groups each. The primary theme from the parent groups was Concerns for Transition to Self-Care with the subthemes of facilitation versus direction and recognition of personal habits. The primary theme identified from the adolescent groups was Taking Control with subthemes of managing symptoms, cognitive dissonance, support, and balance. CONCLUSIONS Study findings provide insight into the experiences of adolescents with PCOS and their parents as they navigate both a family-level transition in health habits and anticipate the adolescent transition to self-management as an emerging adult. PRACTICE IMPLICATIONS Nurses and other health care providers can help facilitate transition to self-management among adolescents with PCOS by encouraging increased independence in health behavior decisions while they are still living at home. Middle and older adolescents who begin to take ownership of their physical activity, nutritional choices, and sleep hygiene will have a firm foundation on which to build as they transition into life beyond high school.
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Affiliation(s)
- Cara C Young
- University of Texas at Austin, School of Nursing, TX, United States of America.
| | - Lynn Rew
- University of Texas at Austin, School of Nursing, TX, United States of America
| | - Maria Monge
- The University of Texas at Austin, Dell Medical School, TX, United States of America
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15
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Sadeeqa S, Mustafa T, Latif S. Polycystic Ovarian Syndrome-Related Depression in Adolescent Girls: A Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2018; 10:55-59. [PMID: 29962792 PMCID: PMC5998697 DOI: 10.4103/jpbs.jpbs_1_18] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Polycystic ovarian syndrome (PCOS), a common endocrinal disorder of reproductive age characterized by heterogeneous complications, is nowadays prevailing among females at adolescent stage. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can occur in women with PCOS. In adolescents, infrequent or absence of menstruation may raise chances for this condition. The increased prevalence of PCOS among general population throughout the world is found to be 5%-10% in the women of reproductive age, and about 40% women with PCOS experience depression, particularly young girls. The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications. Depression and anxiety are common in women with PCOS but are often overlooked and therefore left untreated. Along with the physical disturbances, many mental problems are also associated with PCOS. Therefore, PCOS not only has problems associated with reproduction but also has associated crucial metabolic and psychological health risks with increasing age of the patients. Because of the increased number of cases with PCOS around the world in present times, with prominent symptom of, specifically, depression at the adolescent stage, it is important to highlight the disease.
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Affiliation(s)
- Saleha Sadeeqa
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Tehreem Mustafa
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Sumaira Latif
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
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