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Wang L, Su S, Xiong T, Wang M, Ding R, Tan H, Zhu M. Prevalence and associated risk factors for depression symptoms in adolescent girls with polycystic ovary syndrome: a hospital-based cross-sectional study. Front Public Health 2024; 12:1454415. [PMID: 39234096 PMCID: PMC11371562 DOI: 10.3389/fpubh.2024.1454415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 07/23/2024] [Indexed: 09/06/2024] Open
Abstract
Background Depression symptoms are a growing concern for adolescent girls with PCOS around the world. However, relatively small samples have given varying reports of its prevalence and risk factors in previous studies. Therefore, there is an urgent need for further research on the prevalence and associated factors of depression among adolescent girls with PCOS. Methods A cross-sectional study was performed from October 2021 to May 2022 using a questionnaire and examination of the medical records of a convenience sample of 335 adolescent girls with PCOS. The Chinese version of the Children's Depression Scale (CDI) was used to investigate depression symptoms. A multivariate logistic regression model was used to determine factors that were significantly associated with depression symptoms. Results The prevalence of depression symptoms was 36.12% among adolescent girls with PCOS. A multivariate logistic regression model identified significant factors as perceived social support (95% CI: 0.921 ~ 0.965%, p = 0.000), sleep quality (95% CI: 1.134 ~ 1.324%, p = 0.000), belief illness (95% CI, 1.040 ~ 1.102%, p = 0.000), hirsutism (95% CI, 1.292 ~ 4.392%, p = 0.005), and LH/FSH ≥ 2 (95% CI, 1.939 ~ 6.369%, p = 0.000). Conclusion Depression symptoms are an important problem among adolescent girls with PCOS in China. A comprehensive approach that encompasses social support, structured health education for the disease, and evaluation of the psychological status of PCOS girls with hirsutism (and) or LH/FSH ≥ 2 in time is important to minimize depression symptoms and improve psychological health among adolescent girls with PCOS.
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Affiliation(s)
- Lianhong Wang
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing School of Zunyi Medical University, Zunyi, Guizhou, China
| | - Sihui Su
- Department of Obstetrics, Tongzi People's Hospital, Zunyi, Guizhou, China
| | - Tingting Xiong
- Department of Reproductive Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Meili Wang
- Department of Geriatric Medicine, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Rui Ding
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing School of Zunyi Medical University, Zunyi, Guizhou, China
| | - Huiwen Tan
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing School of Zunyi Medical University, Zunyi, Guizhou, China
| | - Minglan Zhu
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
- Nursing School of Zunyi Medical University, Zunyi, Guizhou, China
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Topkara S, Gayretli TK, Kucukkayikci AS, Kurt D, Ergorun SK, Eryilmaz T, Sucu S, Soysal Ç. Cyberchondria levels in adolescent patients with polycystic ovary syndrome in the digital age. J Pediatr Adolesc Gynecol 2024:S1083-3188(24)00271-7. [PMID: 39168278 DOI: 10.1016/j.jpag.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 08/05/2024] [Accepted: 08/09/2024] [Indexed: 08/23/2024]
Abstract
STUDY OBJECTIVE Cyberchondria is defined as a form of anxiety characterized by excessive health searches on the Internet. Our aim in this study is to investigate the extent of cyberchondria in adolescents with polycystic ovary syndrome and to compare them with adolescents of the same age. METHODS 426 adolescents who presented to clinic between April 2023 and September 2023 and agreed to participate in the study were included in the study. Patients were divided into two groups: polycystic ovary syndrome (PCOS) group (135 patients) and control group (291 patients). The Cyberchondria Severity Scale (CSS) was administered to participants face-to-face. The CSS and subscale scores of both patient groups were analyzed and compared. RESULTS Total CSS scores were significantly different between groups (p=.007) with a mean value of 72 (59-83) in the control group and 77 (63-91) in the PCOS group. When cyberchondria subscales were analysed, statistical difference was found between the groups in the subcategories of compulsion (p:0.015), distress (p:0.039), excessiveness (p:0.028) and mistrust of medical professional (p:0.005). CONCLUSIONS Adolescents with PCOS demonstrated higher levels of cyberchondria which could aggravate associated symptoms of anxiety and depression. Health providers should be mindful to evaluate internet use in this patient population and provide anticipatory guidance.
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Affiliation(s)
- Serap Topkara
- Ankara Etlik City Hospital, Department of Gynecology and Obstetrics, Varlik Mahallesi, Halil Sezai Erkut Caddesi Yenimahalle, Ankara, Turkey.
| | | | | | - Dilara Kurt
- Ankara Etlik City Hospital, Department of Gynecology and Obstetrics, Ankara, Turkey.
| | - Samet Kutluay Ergorun
- Ankara Etlik City Hospital, Department of Gynecology and Obstetrics, Ankara, Turkey.
| | - Tahir Eryilmaz
- Ankara Etlik City Hospital, Department of Gynecology and Obstetrics, Ankara, Turkey.
| | - Sadun Sucu
- Ankara Etlik City Hospital, Department of Perinatology, Ankara, Turkey.
| | - Çağanay Soysal
- Ankara Etlik City Hospital, Department of Gynecology and Obstetrics, Ankara, Turkey.
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Barbagallo F, Tiranini L, Placentino C, Mariacci G, Piccinino M, Cucinella L, Calogero AE, Nappi RE. Body Image and Other Mood Vulnerabilities in Adolescents with Polycystic Ovary Syndrome and Metabolic Alterations. CHILDREN (BASEL, SWITZERLAND) 2024; 11:521. [PMID: 38790516 PMCID: PMC11119722 DOI: 10.3390/children11050521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/21/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Psychological vulnerability is a relevant component of polycystic ovarian syndrome (PCOS), but it is still under-explored, especially during adolescence. The aim of this study was to describe a selection of psychometric characteristics in a clinical sample of Italian adolescents with PCOS. Moreover, we reported the associations of body image, eating attitudes, and mood with metabolic features. METHODS Our sample included 128 adolescent girls (age range: 14-19 years) with PCOS. Validated psychometric questionnaires were administered: State Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Body Attitude Test (BAT), Bulimia Investigation Test (BITE), Eating Attitudes Test (EAT), and Perceived Stress Scale (PSS). RESULTS Anxiety was the most prevalent mood disorder (63.1% trait anxiety and 57% state anxiety). Our cohort also showed a high prevalence of depression (39.1%), body image dissatisfaction (49.2%), disordered eating (11.7%), and bulimic risk (41.4%). PCOS adolescents with obesity and insulin resistance (IR) had statistically significant higher body image distress compared to those with normal weight and without IR (p < 0.001). The Sobel test for mediation showed that body image dissatisfaction mediates the relationship between state anxiety and bulimic risk (Z = 3.42, p < 0.001) and between depression and bulimic risk (Z = 4.59, p < 0.001). CONCLUSIONS A considerable number of patients with PCOS experience psychological disorders during adolescence. IR and obesity play a role in the distress associated with body image, further contributing to psychological vulnerability, especially in the bulimic domain. A comprehensive biopsychosocial approach in adolescents with PCOS represents the basis for effectively managing and preventing complications arising from both psychological and biological disorders in adulthood.
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Affiliation(s)
- Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (F.B.); (A.E.C.)
| | - Lara Tiranini
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (L.T.); (C.P.); (G.M.); (L.C.)
| | - Chiara Placentino
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (L.T.); (C.P.); (G.M.); (L.C.)
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, 27100 Pavia, Italy;
| | - Giacomo Mariacci
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (L.T.); (C.P.); (G.M.); (L.C.)
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, 27100 Pavia, Italy;
| | - Manuela Piccinino
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, 27100 Pavia, Italy;
| | - Laura Cucinella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (L.T.); (C.P.); (G.M.); (L.C.)
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, 27100 Pavia, Italy;
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (F.B.); (A.E.C.)
| | - Rossella E. Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; (L.T.); (C.P.); (G.M.); (L.C.)
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, 27100 Pavia, Italy;
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Stefanaki K, Karagiannakis DS, Peppa M, Vryonidou A, Kalantaridou S, Goulis DG, Psaltopoulou T, Paschou SA. Food Cravings and Obesity in Women with Polycystic Ovary Syndrome: Pathophysiological and Therapeutic Considerations. Nutrients 2024; 16:1049. [PMID: 38613082 PMCID: PMC11013286 DOI: 10.3390/nu16071049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, constitutes a metabolic disorder frequently associated with obesity and insulin resistance (IR). Furthermore, women with PCOS often suffer from excessive anxiety and depression, elicited by low self-esteem due to obesity, acne, and hirsutism. These mood disorders are commonly associated with food cravings and binge eating. Hypothalamic signaling regulates appetite and satiety, deteriorating excessive food consumption. However, the hypothalamic function is incapable of compensating for surplus food in women with PCOS, leading to the aggravation of obesity and a vicious circle. Hyperandrogenism, IR, the reduced secretion of cholecystokinin postprandially, and leptin resistance defined by leptin receptors' knockout in the hypothalamus have been implicated in the pathogenesis of hypothalamic dysfunction and appetite dysregulation. Diet modifications, exercise, and psychological and medical interventions have been applied to alleviate food disorders, interrupting the vicious circle. Cognitive-behavioral intervention seems to be the mainstay of treatment, while the role of medical agents, such as GLP-1 analogs and naltrexone/bupropion, has emerged.
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Affiliation(s)
- Katerina Stefanaki
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.S.); (T.P.); (S.A.P.)
| | - Dimitrios S. Karagiannakis
- Academic Department of Gastroenterology, Laiko General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Melpomeni Peppa
- Endocrine Unit and Diabetes Center, Second Department of Internal Medicine, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
- 3rd Department of Internal Medicine, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Andromachi Vryonidou
- Department of Endocrinology and Diabetes Center, Hellenic Red Cross Hospital, 11526 Athens, Greece;
| | - Sophia Kalantaridou
- 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 57001 Thessaloniki, Greece
| | - Theodora Psaltopoulou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.S.); (T.P.); (S.A.P.)
| | - Stavroula A. Paschou
- Endocrine Unit and Diabetes Center, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece; (K.S.); (T.P.); (S.A.P.)
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Lalonde-Bester S, Malik M, Masoumi R, Ng K, Sidhu S, Ghosh M, Vine D. Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review. Adv Nutr 2024; 15:100193. [PMID: 38408541 PMCID: PMC10973592 DOI: 10.1016/j.advnut.2024.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder affecting females across the lifespan. Eating disorders (EDs) are psychiatric conditions that may impact the development of PCOS and comorbidities including obesity, metabolic syndrome, and type 2 diabetes. The aim of this scoping review was to determine the prevalence of EDs and disordered eating, and to review the etiology of EDs in PCOS. The review was conducted using search terms addressing PCOS, EDs, and disordered eating in databases, including PubMed, Scopus, PsycINFO, and CINAHL. Structured interviews, self-administered questionnaires, chart review, or self-reported diagnosis were used to identify EDs in 38 studies included in the review. The prevalence of any ED in those with PCOS ranged from 0% to 62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios (ORs) of an elevated ED score compared with controls. In those with PCOS, 30% had a higher OR of bulimia nervosa and binge ED was 3-fold higher compared with controls. Studies were limited on anorexia nervosa and other specified feeding or ED (such as night eating syndrome) and these were not reported to be higher in PCOS. To our knowledge, no studies reported on avoidant/restrictive food intake disorder, rumination disorder, or pica in PCOS. Studies showed strong associations between overweight, body dissatisfaction, and disordered eating in PCOS. The etiologic development of EDs in PCOS remains unclear; however, psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied because of the use of different diagnostic and screening tools. Screening of all individuals with PCOS for EDs is recommended and high-quality studies on the prevalence, pathogenesis of specific EDs, relationship to comorbidities, and effective interventions to treat ED in those with PCOS are needed.
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Affiliation(s)
- Sophie Lalonde-Bester
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mishal Malik
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Reihaneh Masoumi
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Ng
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Simran Sidhu
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Donna Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada.
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Alur-Gupta S, Dokras A, Cooney LG. Management of polycystic ovary syndrome must include assessment and treatment of mental health symptoms. Fertil Steril 2024; 121:384-399. [PMID: 38244713 DOI: 10.1016/j.fertnstert.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine disorder with reproductive and metabolic manifestations affecting millions of women worldwide. The health risks associated with PCOS, however, go beyond physical health. Over the past decade, data have emerged demonstrating a high risk of concurrent mental health conditions, specifically depression and anxiety, but extending into other aspects of psychological health, including body image distress, eating disorders, and sexual dysfunction. International surveys suggest physician knowledge about the mental health associations with PCOS is poor and that patients are often dissatisfied regarding counseling-related psychological issues. We performed a review of mental health comorbidities in individuals with PCOS, including depression, anxiety, body image distress, eating disorders, psychosexual dysfunction, and decreased quality of life, as well as evaluated the impact of common PCOS treatments on these conditions. Most meta-analyses in reproductive age women demonstrate increased risks of these conditions, although data are more limited in adolescents and older adults. In addition, the impact of PCOS treatments on these conditions as well as data on first-line treatments in the PCOS population is limited. All providers involved in the multidimensional care of individuals with PCOS should be aware of these mental health risks to provide appropriate screening, counseling and referral options. Future studies should be designed to evaluate targeted treatment for individuals with PCOS.
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Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York.
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laura G Cooney
- Department of Obstetrics and Gynecology, University of Wisconsin, Middleton, Wisconsin
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Hu R, Geng Y, Huang Y, Liu Z, Li F, Dong H, Ma W, Song K, Zhang M, Zhang Z, Song Y. New insights into the interaction between polycystic ovary syndrome and psychiatric disorders: A narrative review. Int J Gynaecol Obstet 2024; 164:387-420. [PMID: 37458179 DOI: 10.1002/ijgo.14988] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 01/15/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a prevalent endocrine disease characterized by hyperandrogenism, ovulatory dysfunction, and ovarian polycystic changes, which combines with reproductive problems, metabolic disorders, and psychological disorders to exhibit a far-reaching impact on the physical and mental health of women. We reviewed previous research and discovered that psychiatric disorders are more common in PCOS patients and their children, potentially exacerbating the condition and creating a vicious loop. To understand the reasons, relevant articles were collected following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines from PubMed, Web of Science, and Cochrane Library, through December 2022. Evidence suggested that PCOS-related clinical manifestations, hyperandrogenism, insulin resistance, obesity, gut dysbiosis, and other variables may increase the risk of psychiatric disorders in patients. In turn, psychiatric disorders may aggravate the pathologic process of PCOS and increase the difficulty of the treatment. We systematically reported the mechanisms underlying the psychiatric disorders-PCOS interactions, intending to provide potential ways to break the vicious cycle and lay the groundwork for future research. However, research on PCOS and psychiatric disorders were still in initial stages, which limited the scope of this review. More studies are needed to further verify our findings.
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Affiliation(s)
- Runan Hu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuli Geng
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanjing Huang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Liu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan Li
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Haoxu Dong
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenwen Ma
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kunkun Song
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mingmin Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Zhang
- Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yufan Song
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Peerwani G, Rozi S, Lakhdir MPA, Zuberi N, Asad N. Association of depressive symptoms and quality of life in Pakistani youth (15-24 years) with polycystic ovarian syndrome: a web-based analytical cross-sectional study. Front Glob Womens Health 2023; 4:967883. [PMID: 37415597 PMCID: PMC10321523 DOI: 10.3389/fgwh.2023.967883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 05/02/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Polycystic ovarian syndrome (PCOS) is associated with impaired quality of life (QOL) of individuals, predominantly in youth, who are most vulnerable to its impact. Psychological morbidity could be one of the factors influencing QOL. The study investigated the association between depressive symptoms and QOL in Pakistani youth (15-24 years) with PCOS and determined other factors associated with QOL. Methods We conducted an analytical-cross-sectional survey on 213 single Pakistani females aged 15-24 years recruited via a web-based approach. Depression and QOL were assessed through Center-of-Epidemiological-Studies-Depression tool and Polycystic-ovarian-syndrome-quality-of-life-scale. Multiple-linear-regression was used to determine factors associated with QOL, and adjusted regression-coefficients along with a 95% confidence interval were reported. Results The mean QOL score: 2.9 ± 1.1. The domain of obesity had the lowest mean score (2.5 ± 1.6) whereas domain of hirsutism had the highest (3.2 ± 1.9). 172/213 (80%) participants were screened positive for depressive symptoms. Participants with depressive symptoms reported reduced mean QOL scores than respondents with no such symptoms (2.8 ± 1.0 vs. 3.4 ± 1.3, p < 0.001). No differences were found in overall QOL and individual domains between participants 15-19 years (n = 36, 17%) and participants >19-24 years (n = 177, 83%) (2.9 ± 1.1 vs. 2.9 ± 1.1) (p > 0.05). We found a significant interaction between depressive symptoms and PCOS duration, indicating that the estimated mean overall QOL score decreases by 25.1 (-36.6, -13.6) for every year increase in PCOS duration among participants screened positive for depressive symptoms. Furthermore, for those respondents who had family history of PCOS and were not satisfied with their healthcare provider treating PCOS, the estimated mean QOL score was 17.47 (-26.1, -8.8) lower than participants who had no family history of PCOS and were satisfied with their healthcare provider. Other factors associated with reduced quality of life included societal pressure to improve appearance affected by PCOS, parental criticism related to PCOS, education, socioeconomic status, working status and BMI. Conclusion Depressive symptoms with increasing duration of PCOS were significantly associated with reduced QOL. Therefore, to improve the overall QOL of PCOS youth, screening and timely addressing of psychological morbidities should be considered.
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Affiliation(s)
- Ghazal Peerwani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Clinical Research Cardiology, Tabba Heart Institute, Karachi, Pakistan
| | - Shafquat Rozi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | - Nadeem Zuberi
- Department of Obstetrics and Gynaecology, Aga Khan University, Karachi, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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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: 5] [Impact Index Per Article: 5.0] [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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Zaks N, Batuure A, Lin E, Rommel AS, Reichenberg A, Grice D, Bergink V, Fox NS, Mahjani B, Janecka M. Association Between Mental Health and Reproductive System Disorders in Women: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e238685. [PMID: 37071426 PMCID: PMC10114079 DOI: 10.1001/jamanetworkopen.2023.8685] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/04/2023] [Indexed: 04/19/2023] Open
Abstract
Importance Reproductive system and mental health disorders are commonly comorbid in women. Although the causes of this overlap remain elusive, evidence suggests potential shared environmental and genetic factors associated with risk. Objective To investigate the comorbidity between psychiatric and reproductive system disorders, both as broad diagnostic categories and among specific pairs of diagnoses. Data Source PubMed. Study Selection Observational studies published between January 1980 and December 2019 assessing prevalence of psychiatric disorders in women with reproductive system disorders and prevalence of reproductive system disorders in women with psychiatric disorders were included. The study did not include psychiatric and reproductive disorders triggered by life events (eg, trauma, infection, surgery) to address potential confounding. Data Extraction and Synthesis A search yielded 1197 records, of which 50 met the inclusion criteria for the qualitative and 31 for the quantitative synthesis in our study. A random-effects model was used for data synthesis and Egger test and I2 to assess study bias and heterogeneity. Data were analyzed from January to December 2022. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Main Outcomes and Measures Psychiatric and reproductive system disorders. Results A total of 1197 records were identified, of which 50 met the inclusion criteria for qualitative and 31 for quantitative synthesis. Diagnosis of a reproductive system disorder was associated with a 2- to 3-fold increased odds of having a psychiatric disorder (lower bound odds ratio [OR], 2.00; 95% CI, 1.41-2.83; upper bound OR; 2.88; 95% CI, 2.21-3.76). The analysis focused on specific diagnoses described in the literature and found that polycystic ovary syndrome was associated with increased odds of depression (population-based studies OR, 1.71; 95% CI, 1.19-2.45; clinical studies OR, 2.58; 95% CI, 1.57-4.23) and anxiety (population-based studies OR, 1.69; 95% CI, 1.36-2.10; clinical studies OR, 2.85; 95% CI, 1.98-4.09). Chronic pelvic pain was also associated with both depression (OR, 3.91; 95% CI, 1.81-8.46) and anxiety (OR, 2.33; 95% CI, 1.33-4.08). Few studies investigated risk of other reproductive system disorders in women with psychiatric disorders, or reverse associations (risk of reproductive system disorder among women with a psychiatric diagnosis). Conclusions and Relevance In this systematic review and meta-analysis, a high rate of reported co-occurrence between psychiatric and reproductive disorders overall was observed. However, data for many disorder pairs were limited. The available literature focused overwhelmingly on affective disorders in polycystic ovary syndrome, overlooking a substantial portion of disease overlap. As such, the associations between the majority of mental health outcomes and conditions of the female reproductive system are largely unknown.
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Affiliation(s)
- Nina Zaks
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anita Batuure
- Rutgers University, Graduate School of Applied and Professional Psychology, Piscataway, New Jersey
| | - Emma Lin
- Cornell University, Undergraduate Studies, Ithaca, New York
| | - Anna-Sophie Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dorothy Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Tics, OCD and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Veerle Bergink
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Nathan S. Fox
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Behrang Mahjani
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Tics, OCD and Related Disorders, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Janecka
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
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11
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Alur-Gupta S, Dokras A. Considerations in the Treatment of Depression and Anxiety in Women with PCOS. Semin Reprod Med 2023; 41:37-44. [PMID: 38113882 DOI: 10.1055/s-0043-1777720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Women with polycystic ovary syndrome (PCOS) are known to be at a greater risk of depression and anxiety. What is less clear is whether existing treatments for PCOS are effective in managing this increased risk and what the optimal approach to treatment is. In this review, currently available interventions are explored including lifestyle modifications, oral contraceptives, insulin sensitizing agents, psychosocial interventions and psychiatric medications. While data are often conflicting, lifestyle interventions, and cognitive behavioral therapy (CBT) appear most promising in reducing depression and anxiety symptoms in this population. There is an urgent need for large prospective studies to fill gaps in the literature.
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Affiliation(s)
- Snigdha Alur-Gupta
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
| | - Anuja Dokras
- Department of Obstetrics and Gynecology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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12
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Meczekalski B, Niwczyk O, Kostrzak A, Maciejewska-Jeske M, Bala G, Szeliga A. PCOS in Adolescents-Ongoing Riddles in Diagnosis and Treatment. J Clin Med 2023; 12:jcm12031221. [PMID: 36769869 PMCID: PMC9918268 DOI: 10.3390/jcm12031221] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. A diagnosis of PCOS is established when a patient exhibits two of three Rotterdam criteria: oligoovulation or anovulation, excess androgen activity, and polycystic ovarian morphology. The pathogenesis of PCOS, as it affects adolescents, is often discussed in terms of a "two-hit" theory. This refers to a stepwise process in which the first "hit" is an inborn congenitally programmed predisposition, while the second "hit" arises from a provocative factor such as insulin resistance. The dynamic physiological and anatomical changes which occur in puberty make for a challenging diagnosis in this group of patients. It is important to be mindful of the physiological particularities in adolescence which often mimic the symptoms of PCOS. In their first-year post-menarche, approximately 75% of menstruating adolescents report their cycle to last between 21-45 days. Recent studies have shown that regular menstrual cyclicity is only achieved within 2-3 years post-menarche. Anovulation, as a crucial diagnostic element for PCOS, features in about half of early-post-menarchal adolescents. Hirsutism and acne are the most common clinical manifestations of hyperandrogenism, and mild features are developed by most adolescents as a result of elevated androgen levels. Distinguishing between a pathological sign and normal features of maturation is often difficult. A polycystic ovarian morphology (PCOM) through ultrasound has been found in up to 40%, 35%, and 33.3% of patients when assessed at 2, 3, and 4 years, respectively, after menarche. PCOM in adolescence is not associated with future abnormalities in ovulatory rate or menstrual cycle duration. For this reason, international guidelines recommend against the use of pelvic ultrasound until 8 years post-menarche. The primary aim of management is focused mainly on improving hormonal and metabolic status, the prevention of future comorbid complications, and generally improving the overall quality of life in young women with PCOS. Considerable controversy surrounds the choice of optimal pharmacological treatment to address PCOS in adolescents. Reliable studies, which include this sub-section of the population, are very limited. There is a lack of robust and reliable trials in the literature addressing the use of combined oral contraceptives. Further work needs to be undertaken in order to provide safe and effective care to the adolescent population in this regard.
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Affiliation(s)
- Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
- Correspondence: ; Tel.: +48-61-65-99-366; Fax: +48-61-65-99-454
| | - Olga Niwczyk
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Anna Kostrzak
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Marzena Maciejewska-Jeske
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Gregory Bala
- UCD School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Anna Szeliga
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
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13
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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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14
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Bahadori F, Jahanian Sadatmahalleh S, Montazeri A, Nasiri M. Sexuality and psychological well-being in different polycystic ovary syndrome phenotypes compared with healthy controls: a cross-sectional study. BMC Womens Health 2022; 22:390. [PMID: 36155624 PMCID: PMC9509607 DOI: 10.1186/s12905-022-01983-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale. MATERIALS AND METHODS The present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12. RESULTS In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05). CONCLUSION The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women's QoL and sexual function should be considered according to the relevant PCOS phenotypes.
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Affiliation(s)
- Fatemeh Bahadori
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Ali Montazeri
- Population Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Malihe Nasiri
- Department of Biostatistics, Faculty of Medical Sciences, Shahid Beheshti University, Tehran, Iran
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15
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Ding R, Zhou H, Yan X, Liu Y, Guo Y, Tan H, Wang X, Wang Y, Wang L. Development and validation of a prediction model for depression in adolescents with polycystic ovary syndrome: A study protocol. Front Psychiatry 2022; 13:984653. [PMID: 36147974 PMCID: PMC9486103 DOI: 10.3389/fpsyt.2022.984653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The high prevalence and severity of depression in adolescents with polycystic ovary syndrome (PCOS) is a critical health threat that must be taken seriously. The identification of high-risk groups for depression in adolescents with PCOS is essential to preventing its development and improving its prognosis. At present, the routine screening of depression in adolescents with PCOS is mainly performed using scales, and there is no early identification method for high-risk groups of PCOS depression in adolescents. It is necessary to use a warning model to identify high-risk groups for depression with PCOS in adolescents. Methods and analysis Model development and validation will be conducted using a retrospective study. The study will involve normal adolescent girls as the control group and adolescent PCOS patients as the experimental group. We will collect not only general factors such as individual susceptibility factors, biological factors, and psychosocial environmental factors of depression in adolescence, but will also examine the pathological factors, illness perception factors, diagnosis and treatment factors, and symptom-related factors of PCOS, as well as the outcome of depression. LASSO will be used to fit a multivariate warning model of depression risk. Data collected between January 2022 and August 2022 will be used to develop and validate the model internally, and data collected between September 2022 and December 2022 will be used for external validation. We will use the C-statistic to measure the model's discrimination, the calibration plot to measure the model's risk prediction ability for depression, and the nomogram to visualize the model. Discussion The ability to calculate the absolute risk of depression outcomes in adolescents with PCOS would enable early and accurate predictions of depression risk among adolescents with PCOS, and provide the basis for the formulation of depression prevention and control strategies, which have important theoretical and practical implications. Trial registration number [ChiCTR2100050123]; Pre-results.
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Affiliation(s)
- Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Heng Zhou
- Reproductive Medicine Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Nursing College, Zunyi Medical University, Zunyi, China
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16
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Alnafjan AA, Alkhuriji AF, Alobaid HM, Babay ZA, Khalil MI. Association of FTO gene variants rs9939609 and rs1421085 with polycystic ovary syndrome. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00263-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Polycystic ovary syndrome (PCOS) is among the most common complex genetic endocrinopathy, and its etiology and pathophysiology remain controversial. FTO is a large highly polymorphic gene and was coined as the first locus associated with adiposity. The association of the intronic variant FTO rs9939609 or FTO rs1421085 with PCOS has been controversial and unclear, mainly due to ethnic differences among populations. The present study aims to investigate the association of FTO rs9939609 or FTO rs1421085 polymorphisms with PCOS in Saudi Arabian women.
Results
A total of 98 PCOS patients and 99 healthy females were included in this study. PCR and genotyping (TaqMan®SNP Genotyping Assay) were employed. For FTO rs9939609, the genotype TA and the recessive model (TA + AA) in PCOS patients were significantly different compared with control subjects (p = 0.008 and p = 0.007, respectively). The allele frequency of the FTO rs9939609 gene variant was associated significantly (p = 0.027) with PCOS, suggesting that the A allele is a risk factor for PCOS susceptibility. However, for the FTO rs1421085 variant, the genotype and allele distributions did not differ significantly between PCOS patients and controls (p > 0.05).
Conclusions
This is the first report to study the association of FTO rs9939609 and FTO rs1421085 with PCOS in Saudi women. Results suggest that the FTO rs9939609 gene variant could be a genetic predisposing factor for PCOS Saudi women.
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17
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Cioana M, Deng J, Nadarajah A, Hou M, Qiu Y, Chen SSJ, Rivas A, Banfield L, Alfaraidi H, Alotaibi A, Thabane L, Samaan MC. Prevalence of Polycystic Ovary Syndrome in Patients With Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2147454. [PMID: 35166782 PMCID: PMC8848210 DOI: 10.1001/jamanetworkopen.2021.47454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE The prevalence of pediatric type 2 diabetes (T2D) is increasing globally. Girls with T2D are at risk of developing polycystic ovary syndrome (PCOS), but the prevalence of PCOS among girls with T2D is unknown. OBJECTIVE To determine the prevalence of PCOS in girls with T2D and to assess the association of obesity and race with this prevalence. DATA SOURCES In this systematic review and meta-analysis, MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science: Conference Proceedings Citation Index-Science, and the gray literature were searched from inception to April 4, 2021. STUDY SELECTION Two reviewers independently screened for studies with observational study design that recruited 10 or more participants and reported the prevalence of PCOS in girls with T2D. DATA EXTRACTION AND SYNTHESIS Risk of bias was evaluated using a validated tool, and level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine criteria. A random-effects meta-analysis was performed. This study follows the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. MAIN OUTCOMES AND MEASURES The main outcome of this systematic review was the prevalence of PCOS in girls with T2D. Secondary outcomes included assessing the associations of obesity and race with PCOS prevalence. RESULTS Of 722 screened studies, 6 studies involving 470 girls with T2D (mean age at diagnosis, 12.9-16.1 years) met the inclusion criteria. The prevalence (weighted percentage) of PCOS was 19.58% (95% CI, 12.02%-27.14%; I2 = 74%; P = .002). Heterogeneity was moderate to high; however, it was significantly reduced after excluding studies that did not report PCOS diagnostic criteria, leading to a calculated prevalence (weighted percentage) of 24.04% (95% CI, 15.07%-33.01%; I2 = 0%; P = .92). Associations with obesity and race could not be determined because of data paucity. CONCLUSIONS AND RELEVANCE In this meta-analysis, approximately 1 in 5 girls with T2D had PCOS, but the results of this meta-analysis should be considered with caution because studies including the larger numbers of girls did not report the criteria used to diagnose PCOS, which is a challenge during adolescence. The associations of obesity and race with PCOS prevalence among girls with T2D need further evaluation to help define at-risk subgroups and implement early assessment and treatment strategies to improve management of this T2D-related comorbidity.
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Affiliation(s)
- Milena Cioana
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Jiawen Deng
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Maggie Hou
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Yuan Qiu
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sondra Song Jie Chen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Haifa Alfaraidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Division of Endocrinology, Department of Pediatrics, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahlam Alotaibi
- Department of Pediatrics, Division of Pediatric Endocrinology, King Abdullah bin Abdulaziz University Hospital, Princess Noura University, Riyadh, Saudi Arabia
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St Joseph’s Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - M. Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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18
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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: 2] [Impact Index Per Article: 1.0] [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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19
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Tan H, Gao L, Guo Y, Liu Y, Ding R, Yan X, Wang X, Wang Y, Wang L. Development and evaluation of a psychological adjustment communication system for adolescents with polycystic ovary syndrome at a high risk of depression: A mixed-method study protocol. Front Psychiatry 2022; 13:937280. [PMID: 36458120 PMCID: PMC9705960 DOI: 10.3389/fpsyt.2022.937280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Depression is a serious psychological disorder that causes substantial psychological and physical suffering in adolescents, contributes to over 50% of suicide attempts, and affects the health status and psychosocial functioning of 25% of the adult population. The prevalence of polycystic ovary syndrome (PCOS) in adolescents is 5.6∼11.04%, and the prevalence of depression in adolescents with PCOS is as high as 50-60%. Depression seriously affects the rehabilitation and quality of life of adolescents with PCOS. In this study, we present a protocol for a mixed-method study to develop and evaluate the effectiveness of a psychological adjustment communication system for reducing the prevalence of depression among adolescents with PCOS who are at a high risk of depression in China. This study utilizes social support theory to develop a mobile phone-based intervention for adolescents with PCOS at a high risk of depression. METHODS This sequential exploratory mixed-method study consists of four consecutive phases. In the first phase, we will review the literature to understand the disease experience and needs of adolescents with PCOS to construct an initial psychological adjustment communication system. In the second phase, researchers will interview patients and their parents using purposeful sampling methods and semi-structured interviews to appropriately modify the psychological adjustment communication system. In the third phase, the Delphi method will be used to improve the psychological adjustment communication system. The fourth phase will employ a quantitative approach using a before-and-after design to measure the effectiveness of the system. DISCUSSION The results of this study will indicate the effectiveness of the psychological adjustment communication system in adolescents with PCOS who are at a high risk of depression. REGISTRATION NUMBER ChiCTR2100050123.
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Affiliation(s)
- Huiwen Tan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Li Gao
- Department of Reproductive Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yunmei Guo
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Ying Liu
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Rui Ding
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xin Yan
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Xueting Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Yousha Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
| | - Lianhong Wang
- Nursing Department, Affiliated Hospital of Zunyi Medical University, Zunyi, China.,Nursing College, Zunyi Medical University, Zunyi, China
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20
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Torres-Zegarra C, Sundararajan D, Benson J, Seagle H, Witten M, Walders-Abramson N, Simon SL, Huguelet P, Nokoff NJ, Cree-Green M. Care for Adolescents With Polycystic Ovary Syndrome: Development and Prescribing Patterns of a Multidisciplinary Clinic. J Pediatr Adolesc Gynecol 2021; 34:617-625. [PMID: 33794340 PMCID: PMC8808364 DOI: 10.1016/j.jpag.2021.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE Based on updated guidelines and expressed patient needs, we created a multidisciplinary clinic including endocrinology, gynecology/adolescent medicine, dermatology, psychology, and nutrition to provide comprehensive care to adolescent girls with polycystic ovary syndrome (PCOS). We describe the patient population presenting to this clinic, and prescribing patterns when a multidisciplinary approach is used. DESIGN Retrospective chart review. SETTING Tertiary care hospital. PARTICIPANTS Female patients, aged 11-24 years, presenting for initial assessment in a multidisciplinary PCOS clinic. INTERVENTIONS None. MAIN OUTCOME MEASURES Medical history, physical examination findings, laboratory measurements and prescribed therapies. RESULTS A total of 92 patients seen from 2014 to 2018 are described (age 15.9 years, range 11-24 years, body mass index 35.6 kg/m2, range 19.9-53.5). Metabolic syndrome features were common: 26% had a prediabetes hemoglobin A1c (>5.6%), 83% had a high-density lipoprotein (HDL) <50 mg/dL, 40% had a systolic blood pressure >120 mm Hg, and 43% had an alanine aminotransferase level of >30 U/L. Dermatologic findings included acne 93%, hirsutism 38%, acanthosis nigricans 85%, hidradenitis suppurativa 16%, and androgenic alopecia 2%. Of the patients, 33% had a diagnosis of depression or anxiety, 16% of patients had a diagnosis of obstructive sleep apnea, and an additional 59% had symptoms warranting a sleep study The most commonly prescribed medications were topical acne preparations (62%), followed by estrogen-containing hormonal therapy (56%) and metformin (40%). CONCLUSION In adolescents with PCOS and obesity, metabolic, dermatologic, and psychologic co-morbidities are common. The use of a multidisciplinary clinic model including dermatology in addition to endocrinology, gynecology, psychology, and lifestyle experts provides care for most aspects of PCOS.
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Affiliation(s)
- C Torres-Zegarra
- (1)Department of Surgery, Division of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - D Sundararajan
- Department of Pediatrics, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - J Benson
- Department of Pediatrics, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - H Seagle
- Department of Nutrition, Children's Hospital Colorado, Aurora, Colorado
| | - M Witten
- Department of Nutrition, Children's Hospital Colorado, Aurora, Colorado
| | - N Walders-Abramson
- Department of Pediatrics, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - S L Simon
- Department of Pediatrics, Division of Pulmonary and Sleep Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - P Huguelet
- Department of Obstetrics and Gynecology, Section of Pediatric and Adolescent Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - N J Nokoff
- Department of Pediatrics, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - M Cree-Green
- Department of Pediatrics, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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21
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Asanidze E, Kristesashvili J, Parunashvili N, Karelishvili N, Etsadashvili N. Challenges in diagnosis of polycystic ovary syndrome in adolescence. Gynecol Endocrinol 2021; 37:819-822. [PMID: 34184963 DOI: 10.1080/09513590.2021.1943344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE we evaluated clinical features, the hormonal status, and ovarian morphological characteristics using ultrasound (US) in adolescents with polycystic ovary syndrome (PCOS) and an 'increased risk' of PCOS, and compared the data to age-matched controls. METHODS the prospective study involved 154 adolescents (≥2 and <8 years post menarche): Group I-adolescents with PCOS (n = 60), Group II- adolescents with an 'increased risk' of PCOS (n = 48), and Group III- control group (n = 46). PCOS patients met all 3 diagnostic criteria of the Rotterdam consensus (2003), an 'increased risk' of PCOS was accepted as 'menstrual irregularities and clinical and/or biochemical hyperandrogenism'. RESULTS In adolescents with PCOS and 'increased risk' of PCOS, AMH and SHBG did not differ significantly. In Group I and Group II, the average AMH level was significantly higher, while SHBG was significantly lower than in the controls (p < .001). Androgen levels and mFG in Group I and Group II did not differ significantly, but were significantly higher than in controls (p < .001). In Group I, index of insulin resistance and the number of antral follicles (AFC) were significantly higher than in the comparison groups (p < .05). There was no significant difference in ovarian volume between comparison groups (p < .001). CONCLUSIONS A combination of AMH, SHBG, clinical and biochemical hyperandrogenism and menstrual irregularities may be considered as diagnostic markers of PCOS in adolescents and for the identification of a 'risk group' for developing PCOS. Ultrasound estimation of AFC are a more specific marker of ovarian morphology in adolescents with PCOS, rather than ovary volume.
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Affiliation(s)
- Elene Asanidze
- Department of Medical Faculty, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Jenaro Kristesashvili
- Department of Medical Faculty, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Nino Parunashvili
- Department of Medical Faculty, Physician Assistant Program, University of Toronto, Toronto, Canada
| | - Natalia Karelishvili
- Department of Medical Faculty, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Nana Etsadashvili
- Department of Medical Faculty, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
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22
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Aversa A, La Vignera S, Rago R, Gambineri A, Nappi RE, Calogero AE, Ferlin A. Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. Front Endocrinol (Lausanne) 2021. [PMID: 32849300 DOI: 10.3389/fendo.2020.00516.pmid:32849300;pmcid:pmc7431619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rocco Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University Alma Mater Studiorum, Bologna, Italy
| | - Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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23
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Self-Concept, Depression, and Anxiety Levels of Adolescents with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol 2021; 34:311-316. [PMID: 33347988 DOI: 10.1016/j.jpag.2020.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 12/20/2022]
Abstract
STUDY OBJECTIVE In this study we explored the level and severity of issues related to self-concept, depression, and anxiety in adolescents with polycystic ovary syndrome (PCOS). DESIGN Cross-sectional and case-control study. SETTING The research was conducted in the outpatient Pediatric Endocrinology Clinic of Adiyaman University School of Medicine in Turkey. PARTICIPANTS The study population comprised 153 patients with PCOS and 161 healthy adolescents. INTERVENTIONS AND MAIN OUTCOME MEASURES The Personal Information Form, State-Trait Anxiety Inventory for Children, Children's Depression Inventory, and Piers-Harris Children's Self-Concept Scale were administered to all of the participants who took part in the study. RESULTS The Piers-Harris Children's Self-Concept Scale scores were lower in the PCOS group than in the control group (P < .001). In addition, the scores for the Children's Depression Inventory were also significantly higher in the PCOS group (P < .001). The State-Trait Anxiety Inventory for Children scores showed statistically significant higher levels of state anxiety and trait anxiety in the PCOS group (P < .001). CONCLUSION Adolescents with PCOS had lower self-concept scores, greater anxiety levels, and increased depressive symptoms than the healthy controls. Future studies are needed to examine the psychiatric problems in adolescents with PCOS.
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24
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Lin H, Liu M, Zhong D, Ng EHY, Liu J, Li J, Shi Y, Zhang C, Wen X, Mai Z, Ou M, Ma H. The Prevalence and Factors Associated With Anxiety-Like and Depression-Like Behaviors in Women With Polycystic Ovary Syndrome. Front Psychiatry 2021; 12:709674. [PMID: 34744814 PMCID: PMC8563587 DOI: 10.3389/fpsyt.2021.709674] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/16/2021] [Indexed: 02/04/2023] Open
Abstract
Increasing evidence shows that polycystic ovary syndrome (PCOS) patients are particularly vulnerable to anxiety/depression-like behaviors. This study sought to determine the prevalence of anxiety/depression-like behaviors among women with PCOS and to identify factors associated with these behaviors. This study was a secondary analysis of three studies performed on Chinese women who were aged 18 to 40 and diagnosed with PCOS according to the modified Rotterdam criteria. We obtained 802 useable responses for the self-rating anxiety scale and 798 responses for the self-rating depression scale. The prevalence of anxiety-like and depression-like behaviors among women with PCOS was 26.1% (209/802) and 52.0% (415/798), respectively. Anxiety-like behaviors were associated with age, body image-related factors (including body mass index and waist-to-hip ratio), and hyperandrogenism-related factors (including free androgen index and hirsutism). Depression-like behaviors were associated with age, body image-related factors, hyperandrogenism-related factors, and metabolic factors (including fasting insulin, fasting plasma glucose, and homeostatic model assessment of insulin resistance). Body image-related factors and hyperandrogenism-related factors were related to both anxiety-like behaviors and depression-like behaviors in both infertile and fertile PCOS patients.
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Affiliation(s)
- Han Lin
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingxing Liu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Dongmei Zhong
- Department of Gynecology of Traditional Chinese Medicine, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynecology, the University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, Hong Kong, SAR China
| | - Jianping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Li
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Shi
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chunren Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaohui Wen
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhefen Mai
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Miaoxian Ou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongxia Ma
- Department of Gynecology of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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25
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Sari SA, Celik N, Uzun Cicek A. Body Perception, Self-Esteem, and Comorbid Psychiatric Disorders in Adolescents Diagnosed with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol 2020; 33:691-696. [PMID: 32916303 DOI: 10.1016/j.jpag.2020.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/23/2020] [Accepted: 08/31/2020] [Indexed: 12/22/2022]
Abstract
STUDY OBJECTIVE To investigate adolescents with polycystic ovary syndrome (PCOS) in terms of body perception, self-esteem, and comorbid psychiatric diseases by comparing them with their healthy peers. DESIGN Cross-sectional design. SETTING The Department of Child and Adolescent Psychiatry and the Department of Pediatric Endocrinology outpatient clinic of Cumhuriyet University in Sivas, Turkey. PARTICIPANTS Fifty female adolescents aged 12-18 years who were diagnosed as having PCOS and 37 healthy adolescents aged 12-18 years. INTERVENTIONS AND MAIN OUTCOME MEASURES All adolescents were evaluated by a child and adolescent psychiatrist using a semistructured interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and asked to complete the Rosenberg Self-Esteem Scale, Children's Depression Inventory, and Body Image Scale. RESULTS The rate of psychiatric disorders in the PCOS group was significantly higher than in the control participants (16/50 (32%) vs 5/37 (13.5%), respectively; P = .046). The most common disorder was major depressive disorder. The Rosenberg Self-Esteem Scale and Body Image Scale scores of the PCOS group were lower (P = .03; P < .001, respectively), and Children's Depression Inventory scores were higher (P = .03) than in the control group. There was no significant relationship between obesity, hirsutism, and insulin resistance with any psychiatric disorders in the PCOS group. CONCLUSION Adolescents with PCOS had more psychopathology than their peers. Moreover, their self-esteem was lower and their body perceptions were more dissatisfied compared with their peers.
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Affiliation(s)
- Seda Aybüke Sari
- Department of Child and Adolescent Psychiatry, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey.
| | - Nurullah Celik
- Department of Pediatric Endocrinology, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
| | - Ayla Uzun Cicek
- Department of Child and Adolescent Psychiatry, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
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26
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Wilson NA, Peña AS. Quality of life in adolescent girls with polycystic ovary syndrome. J Paediatr Child Health 2020; 56:1351-1357. [PMID: 32810373 DOI: 10.1111/jpc.15097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/24/2020] [Accepted: 07/06/2020] [Indexed: 12/20/2022]
Abstract
Quality of life (QoL) is an important aspect of health and well-being. QoL is reduced in women with polycystic ovary syndrome (PCOS), but there is limited data in adolescents. This review aimed to assess studies regarding the QoL of adolescent girls with PCOS. Five databases were searched for relevant studies. Studies were included if they were conducted in adolescent girls with PCOS, aged 12-22 years old, and used a questionnaire to measure QoL. The search identified a total of 254 studies, and after exclusions, 11 relevant studies were included in the review. Most studies had a relatively small sample size, but overall included a total of 512 adolescents with PCOS. In most cases, adolescent girls with PCOS have reduced QoL when compared to healthy girls, and PCOS symptoms/excess weight impact on their QoL. Further research is required due to limited data on QoL in adolescents with PCOS of normal weight.
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Affiliation(s)
- Nina A Wilson
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Alexia S Peña
- Discipline of Paediatrics, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia
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27
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Besenek M, Gurlek B. Hyperandrogenism in polycystic ovary syndrome affects psychological well‐being of adolescents. J Obstet Gynaecol Res 2020; 47:137-146. [DOI: 10.1111/jog.14444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/11/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Mert Besenek
- Child and Adolescent Psychiatry Clinic RTE University Education and Research Hospital Rize Turkey
| | - Beril Gurlek
- Obstetrics and Gynecology Department RTE University Education and Research Hospital Rize Turkey
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28
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Saei Ghare Naz M, Ramezani Tehrani F, Behroozi Lak T, Mohammadzadeh F, Nasiri M, Kholosi Badr F, Ozgoli G. Quality of Life and Emotional States of Depression, Anxiety and Stress in Adolescents with Polycystic Ovary Syndrome: A Cross-Sectional Study. Psychol Res Behav Manag 2020; 13:203-209. [PMID: 32184681 PMCID: PMC7053650 DOI: 10.2147/prbm.s241192] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The chronic condition of polycystic ovary syndrome (PCOS) in adolescents can affect different aspects of quality of life in them. This study aimed to determine the correlation between the quality of life with emotional states of depression, anxiety, and stress in adolescents with PCOS. METHODS This is a cross-sectional study conducted on 120 adolescents with PCOS in Tehran, Iran in 2019. The sociodemographic checklist, quality of life, depression, anxiety and stress (DASS) were assayed by valid and reliable questionnaires. The Pearson's correlation coefficient and linear regression were used for data analysis, which was performed by SPSS (V.22). RESULTS The mean (SD) age and menarche age of participants were 16.58 (1.36) and 12.52 (1.19) years, respectively. The most common clinical symptoms of adolescence were irregular menstruation (85%) and acne (61.7%). According to the result of this study, there was a significant reverse correlation between total score of SF-12 with total scores of depression, anxiety and stress (r=-0.395, p=0.001) and a significant reverse correlation was also found between each dimension of DASS scale and 12-Item Short Form Survey (SF-12) (p<0.001). Based on the linear regression model and after controlling the demographic variables, there was a linear regression relationship between total DASS score and SF-12 (Beta= -0.367, p= 0.003). CONCLUSION The study results reveal the role of emotional states of depression, anxiety, and stress in the quality of life of adolescents with PCOS. Based on our findings, we emphasize the interventional studies and guides for improving all dimensions of quality of life and reducing the psychological burden of PCOS in later life of adolescence.
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Affiliation(s)
- Marzieh Saei Ghare Naz
- Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tahereh Behroozi Lak
- Reproductive Health Research Center, Department of Infertility, Urmia University of Medical Sciences, Urmia, Iran
| | - Farnaz Mohammadzadeh
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Biostatistics, Faculty of Paramedic, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | - Giti Ozgoli
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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29
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Aversa A, La Vignera S, Rago R, Gambineri A, Nappi RE, Calogero AE, Ferlin A. Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions. Front Endocrinol (Lausanne) 2020; 11:516. [PMID: 32849300 PMCID: PMC7431619 DOI: 10.3389/fendo.2020.00516] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/26/2020] [Indexed: 12/24/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.
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Affiliation(s)
- Antonio Aversa
- Department of Experimental and Clinical Medicine, University “Magna Graecia”, Catanzaro, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rocco Rago
- Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - Alessandra Gambineri
- Department of Medical and Surgical Science, University Alma Mater Studiorum, Bologna, Italy
| | - Rossella E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- *Correspondence: Alberto Ferlin
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