Psychological Experiences of Adolescent Girls with Polycystic Ovary Syndrome: A Qualitative Study

High Fat Diet and Polycystic Ovary Syndrome (PCOS) in Adolescence: An Overview of Nutritional Strategies

Polycystic ovary syndrome (PCOS) is a multifaceted and heterogeneous disorder, linked with notable reproductive, metabolic, and psychological outcomes. During adolescence, key components of PCOS treatment involve weight loss achieved through lifestyle and dietary interventions, subsequently pursued by pharmacological or surgical therapies. Nutritional interventions represent the first-line therapeutic approach in adolescents affected by PCOS, but different kinds of dietary protocols exist, so it is necessary to clarify the effectiveness and benefits of the most well-known nutritional approaches. We provided a comprehensive review of the current literature concerning PCOS definition, pathophysiology, and treatment options, highlighting nutritional strategies, particularly those related to high-fat diets. The high-fat nutritional protocols proposed in the literature, such as the ketogenic diet (KD), appear to provide benefits to patients with PCOS in terms of weight loss and control of metabolic parameters. Among the different types of KD studies, very low-calorie ketogenic diets (VLCKD), can be considered an effective dietary intervention for the short-term treatment of patients with PCOS. It rapidly leads to weight loss alongside improvements in body composition and metabolic profile. Even though extremely advantageous, long-term adherence to the KD is a limiting factor. Indeed, this dietary regimen could become unsustainable due to the important restrictions required for ketosis development. Thus, a combination of high-fat diets with more nutrient-rich nutritional regimens, such as the Mediterranean diet, can amplify positive effects for individuals with PCOS.

Mental health latent profiles and emotion regulation in women with polycystic ovary syndrome: A cross-sectional study

This cross-sectional study aimed to identify latent mental health subgroups of reproductive-aged women with polycystic ovary syndrome (PCOS) and examine differences in emotion regulation and social support. A total of 477 samples (age = 27.22 ± 5.37) diagnosed with PCOS were included in this study, all of whom were of the same ethnicity. Latent profile analysis (LPA) was conducted in Mplus version 8.3 to identify mental health latent profiles in women with PCOS based on the dual-factor approach. The current study identified three distinct mental health profiles within women with PCOS: High-Symptom and High-Well-being Profile, Low-Symptom and High-Well-being Profile, and High-Symptom and Low-Well-being Profile, with group proportions of 52.3%, 35.7%, and 11.1%, respectively. This study revealed that cognitive reappraisal and social support are important protective factors for the mental health of women with PCOS, whereas expressive suppression is a negative factor for their mental health.

Effect of using 5A's model for lifestyle counseling on psychological symptoms in women with polycystic ovary syndrome: a randomized field trial

Lifestyle modification in women with polycystic ovary syndrome (PCOS) could be associated with increased psychological symptoms. This study aimed to evaluate the effect of lifestyle modification counseling using 5A's model on the psychological symptoms of women with PCOS. This double-blind, randomized field trial was performed on 70 women with PCOS in two groups of lifestyle modification counseling based on 5A's model and counseling without using the model. The intervention was performed based on five stages of the 5A's model (Assess, Advise, Agree, Assist, Arrange) during a week, and psychological symptoms were assessed using Symptom Checklist-90-R before the intervention and one and three months after the intervention. The results showed that one and three months after the intervention, the level of psychological symptoms, except obsessive-compulsive level, were significantly lower in the intervention group than in the control group (p < 0.05). Moreover, the level of these symptoms decreased over time in the intervention group (p < 0.0001). Using the 5A's model in lifestyle modification counseling is associated with the promotion of psychological health in women with PCOS, and this model is recommended for lifestyle counseling in women with polycystic ovary syndrome.

Prevalence and associated risk factors for mental health problems among patients with polycystic ovary syndrome in Bangladesh: A nationwide cross-Sectional study

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common female reproductive endocrine problem worldwide. The prevalence of mental disorder is increasing among PCOS patients due to various physical, psychological, and social issues. Here we aimed to evaluate the mental health and associated factors among women suffering from PCOS in Bangladesh.

METHODS

We performed an online cross-sectional survey among 409 participants with PCOS using Google Forms. We used structured questionnaires to collect socio-demographic information and lifestyle-related factors. Also, we applied patient health questionnaire (PHQ-9), generalized anxiety disorder (GAD-7) scale, and UCLA loneliness (UCLA-3) scale for psychometric assessment of the participants. Finally, we applied several statistical tools and performed data interpretations to evaluate the prevalence of mental health disorders and associated factors among patients with PCOS in Bangladesh.

RESULTS

Prevalence of loneliness, generalized anxiety disorder and depressive illness among the women with PCOS were 71%, 88%, and 60%, respectively. Among the mental illness, mild, moderate, and severe cases were 39%, 18%, and 14% for loneliness; 39%, 23% and 26% for generalized anxiety disorder; and 35%, 18%, and 7% for depressive disorder. According to the present findings, obesity, financial condition, physical exercise, mealtime, food habit, daily water consumption, birth control method, and long-term oral contraceptive pills contribute to developing mental health disorders among females with PCOS in Bangladesh.

CONCLUSION

According to present study results, high proportion of women suffering from PCOS experience several mental disorders in Bangladesh. Although several socio-demographic and lifestyle-related factors were found to be associated with the poor mental health of women with PCOS; however, PCOS itself is a condition that favors poor physical and psychological health. Therefore, we recommend proper treatment, public awareness, and a healthy lifestyle to promote the good mental health of women suffering from PCOS.

Prediction of PCOS and Mental Health Using Fuzzy Inference and SVM

Polycystic ovarian syndrome (PCOS) is a hormonal disorder found in women of reproductive age. There are different methods used for the detection of PCOS, but these methods limitedly support the integration of PCOS and mental health issues. To address these issues, in this paper we present an automated early detection and prediction model which can accurately estimate the likelihood of having PCOS and associated mental health issues. In real-life applications, we often see that people are prompted to answer in linguistic terminologies to express their well-being in response to questions asked by the clinician. To model the inherent linguistic nature of the mapping between symptoms and diagnosis of PCOS a fuzzy approach is used. Therefore, in the present study, the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is evaluated for its performance. Using the local yet specific dataset collected on a spectrum of women, the Fuzzy TOPSIS is compared with the widely used support vector machines (SVM) algorithm. Both the methods are evaluated on the same dataset. An accuracy of 98.20% using the Fuzzy TOPSIS method and 94.01% using SVM was obtained. Along with the improvement in the performance and methodological contribution, the early detection and treatment of PCOS and mental health issues can together aid in taking preventive measures in advance. The psychological well-being of the women was also objectively evaluated and can be brought into the PCOS treatment protocol.

Providing lifestyle advice to women with PCOS: an overview of practical issues affecting success

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting up to 13 % of women. Lifestyle interventions are first-line treatments, however attrition in women with PCOS is high. This review summarises current evidence on barriers to lifestyle management in PCOS and suggested strategies for overcoming these challenges, mapped to the Capability, Opportunity, Motivation and Behaviour model.Physical capability for lifestyle changes may be impacted by altered gut hormone regulation and energy expenditure in PCOS. This may contribute to difficulties with weight management. The higher prevalence of eating disorders, disordered eating, fatigue and sleep disturbances are further barriers. Psychological capability may be reduced due psychological symptoms and lack of critical health literacy. Women with PCOS face similar challenges in terms of Opportunity to make lifestyle changes as other women of reproductive age. However, these are complicated by features more common in PCOS including body dissatisfaction. Motivation to adopt healthy lifestyles may be impacted by suboptimal risk perception and intrinsic motivation.To address these barriers, screening for and management of eating disorders, disordered eating, depression, and Obstructive Sleep Apnoea should be undertaken as per international evidence-based guidelines. A weight-neutral approach may be appropriate with disordered eating. Building capability among health professionals to better partner with women with PCOS on their management is essential in addressing health literacy gaps. Behavioural strategies that target risk perception and build intrinsic motivation should be utilised. More research is required to understand optimal self-management strategies, risk perception, energy homeostasis and overcoming attrition in women with PCOS.

Weight Management in Adolescents with Polycystic Ovary Syndrome

PURPOSE OF REVIEW

Polycystic ovary syndrome (PCOS) is a common condition that clinically presents during adolescence. PCOS is associated with increased rates of overweight and obesity, as well as higher rates of metabolic disease, especially type 2 diabetes. Weight loss decreases PCOS symptoms and risk for metabolic disease. The goal of this review is to evaluate recent studies describing the hormonal, metabolic, and weight effects of different weight loss strategies: dietary, physical activity, pharmacotherapy, bariatric surgery, mood modification, and sleep.

RECENT FINDINGS

Calorie restriction continues to be supported as the primary nutrition intervention to achieve weight loss in individuals with PCOS, and a dietary macronutrient composition with lower compared to higher glycemic carbohydrates may be more effective. There is limited data that vitamins, nutraceuticals, and probiotics may improve hormonal and metabolic outcomes. Most types of physical activity are effective in improving outcomes in PCOS and lowering weight. Whereas there are promising data on anti-obesity medications such as glucagon-like peptide-1 receptor agonists in adults with PCOS and adolescents with obesity, further work is needed to know if these therapies are effective in youth with PCOS. Research is lacking on the effectiveness of other anti-obesity medications in PCOS. Bariatric surgery is especially promising for decreasing weight in adults and youth, and reversing type 2 diabetes in youth, though PCOS data are lacking. Treatment of depression in adolescents with insulin resistance and women with PCOS is associated with improved weight loss. Adolescents with PCOS and obesity may have greater sleep-related risks including circadian misalignment and obstructive sleep apnea, interventions for which have not yet been conducted. Clinical trials on weight loss strategies in adolescents with PCOS remain limited, with most information inferred from studies in women with PCOS or adolescents with obesity. However, there are multiple options to optimize weight loss in dietary, activity, pharmacotherapy, bariatric surgery, mood modification, and sleep domains.

Polycystic Ovary Syndrome in Insulin-Resistant Adolescents with Obesity: The Role of Nutrition Therapy and Food Supplements as a Strategy to Protect Fertility

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in young reproductive-aged women. PCOS is often associated with obesity and impairs reproductive health. Even though several theories have been proposed to explain the pathogenic mechanism of PCOS, the role of insulin resistance (IR) as a key etiological component, independently of (but amplified by) obesity, is well recognized. The consequent hyperinsulinemia activates excessive ovarian androgen production, leading to PCOS. Additionally, the state of chronic inflammation related to obesity impacts ovarian physiology due to insulin sensitivity impairment. The first-line treatment for adolescents with obesity and PCOS includes lifestyle changes; personalized dietary interventions; and, when needed, weight loss. Medical nutrition therapy (MNT) and the use of specific food supplements in these patients aim at improving symptoms and signs, including insulin resistance and metabolic and reproductive functions. The purpose of this narrative review is to present and discuss PCOS in adolescents with obesity, its relationship with IR and the role of MNT and food supplements in treatment. Appropriate early dietary intervention for the management of adolescents with obesity and PCOS should be considered as the recommended approach to restore ovulation and to protect fertility.

Barriers to Occupational Therapy Fieldwork Education in Iran: The Perspectives of Fieldwork Educators and Students

Background

Clinical education is a vital factor in the process of learning in medical sciences universities. The aim of the present study was to explore the perspectives of fieldwork educators and students concerning barriers to occupational therapy fieldwork education in Iran.

Materials and Methods

A qualitative research was conducted from May 2019 to April 2020 to address the study objectives. The data analysis was performed using conventional content analysis based on Graneheim and Lundman's approach. Purposive sampling was used to enroll 12 educators and 14 students of various backgrounds (physical disabilities-adult, physical disabilities-pediatrics, psychosocial-adult, and psychosocial-pediatrics) in the study.

Results

The findings indicated that the main themes were related to fieldwork educators, fieldwork settings, educational planning, students, and educational regulation.

Conclusions

It can be concluded that the perspectives of students and occupational therapy educators regarding the field of clinical education are not only important but also useful for the attainment of effective clinical education and the development of knowledge related to rehabilitation nursing education. Therefore, educational planners should develop effective programs based on these themes.