Polikistik Over Sendromlu Hastalarda Premenstrüel Disforik Bozukluk ve Affektif Mizaç
GİRİŞ ve AMAÇ: Bu çalışmada, Polikistik Over Sendromu (PKOS) olan kadınların, afektif mizaç özelliklerini ve Premenstrual Disforik Bozukluk (PMDB) komorbiditesini değerlendirmek ve Sağlıklı Kontrollerle (SK) karşılaştırmayı hedefledik. YÖNTEM ve GEREÇLER: Bu çalışmaya 20 PKOS hastası ve 20 SK dahil edildi. Tüm katılımcılara Hastane Anksiyete ve Depresyon Ölçeği (HADÖ) ve Mizaç Karakter Envanteri (Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A)) uygulandı. PMDB ve diğer psikiyatrik bozuklukların tanıları, DSM-5 tanı ölçütlerini kullanarak tüm katılımcılarla bire bir görüşen uzman psikiyatristler tarafından yapıldı. BULGULAR: PKOS'lu hastalarda PMDB'nin eştanısı% 30 (n = 6) iken SK grubunda % 15 (n = 3) idi. PMDB oranları bakımından gruplar arasında anlamlı farklılık gözlenmedi. PKOS'lu hastalarda SK'lere göre daha yüksek oranda majör depresyon (% 25, n = 5) ve anksiyete bozukluğu (% 20, n = 4) olmakla birlikte, sadece anksiyete bozuklukları PKOS'da SK grubuna göre anlamlı derecede yüksekti (p = 0.03). TARTIŞMA ve SONUÇ: PKOS'lu hastalar, DSM-5’e göre duygudurum bozuklukları arasında olan ve adet döngüsü ile ilişkili olan PMDB komorbiditesi açısından risk faktörüne sahip olabilirler. PKOS’lu kadınlarda, PMDB ve diğer psikiyatrik durumları düşünmek ve tedavi etmek, bu hastaların yaşam kalitesini ve işlevselliğini artırabilir.
Premenstrual Dysphoric Disorder and Affective Temperament in Patients with Polycystic Ovary Syndrome
INTRODUCTION: This study aimed to evaluate the affectivetemperaments of women with Polycystic Ovary Syndrome(PCOS), to assess its comorbidity with PremenstrualDysphoric Disorder (PMDD) and compare with HealthyControls (HC).METHODS: A total of 20 women with PCOS and 20 HC wereincluded in this study. Hospital Anxiety and Depression Scale(HADS) and Temperament Evaluation of Memphis, Pisa, Parisand San Diego-Autoquestionnaire version (TEMPS-A) wereapplied to all participants. The Diagnoses of PMDD and otherpsychiatric disorders were made by staff psychiatristsinterviewing all participants using DSM-5 diagnostic criteria.RESULTS: The comorbidity of PMDS in patients with PCOSwas 30% (n=6), while it was 15% (n=3) in the HC group.PMDS proportions did not differ significantly between groups.Patients with PCOS had higher major depression (25%, n=5)and anxiety disorders (20%, n=4) compared with HCs, butonly anxiety disorders were significantly higher in PCOS thanthe HC group (p=0.03).DISCUSSION and CONCLUSION: Patients with PCOS mayhave more comorbidity risk of PMDD, which is a mooddisorder according to DSM–5, and associated with menstrualcycles. Considering and treating PMDD and other psychiatricconditions may increase the quality of life and functionality ofwomen with PCOS.
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- 1. Ehrmann DA. Polycystic ovary syndrome. N
Engl J Med 2005;11:1223–36.
- 2. Li Y, Li Y, Yu Ng EH, Stener-Victorin E,
Hou L, Wu T, et al. Polycystic ovary syndrome is
associated with negatively variable impacts on
domains of health-related quality of life: evidence
from a meta-analysis. Fertil Steril 2011;96: 452–8.
- 3. Hahn S, Janssen OE, Tan S, Pleger K, Mann
K, Schedlowski M, et al. Clinical and psychological
correlates of quality-of-life in polycystic ovary
syndrome. Eur J Endocrinol 2005;11:853–60.
- 4. Setji, TL, Brown AJ. Polycystic ovary
syndrome: update on diagnosis and treatment. Am J
Med 2014;127:912–9.
- 5. Davari-Tanha F, Hosseini Rashidi B,
Ghajarzadeh M, Noorbala AA. Bipolar disorder in
women with polycystic ovarian syndrome (PCOS).
Acta Med Iran 2014;52(1):46–8.
- 6. Kerchner A, Lester W, Stuart SP, Dokras A.
Risk of depression and other mental health
disorders in women with polycystic ovary
syndrome: a longitudinal study. Fertil Steril
2009;91(1):207–12.
- 7. Bhattacharya SM, Jha A. Prevalence and risk
of depressive disorder in women with polycystic
ovary syndrome (PCOS). Fertil Steril 2010;94:357–
9.
- 8. Jedel E, Waern M, Gustafson D, Landén M,
Eriksson E, Holm G, et al. Anxiety and depression
symptoms in women with polycystic ovary
syndrome compared with controls matched for
body mass index. Hum Reprod 2010;25(2):450-6.
- 9. Naqvi SH, Moore A, Bevilacqua K, Lathief
S, Williams J, Naqvi N, et al. Predictors of
depression in women with polycystic ovary
syndrome. Arch Womens Ment Health 2015;18:95–
101.
- 10. American Psychiatric Association.
Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition. Arlington, VA: American
Psychiatric Association; 2013.
- 11. Nevatte T, O 'Brien PM, Backstrom T,
Brown C, Dennerstein L, Endicott J, et al. Is PMD
consensus on the management of premenstrual
disorders. Arch Women Ment Health 2013;1 6:279
-91.
- 12. Yonkers KA, O'Brien PM, Eriksson E.
Premenstrual syndrome. Lancet 2008;371: 1200 -
1210.
- 13. Akiskal HS, Akiskal KK, Haykal RF,
Manning JS, Connor PD. TEMPS-A: progress
towards validation of a self-rated clinical version of
the Temperament Evaluation of the Memphis, Pisa,
Paris, and San Diego Autoquestionnaire. J Affect
Disord 2005; 85;3 – 16.
- 14. de Aguiar Ferreira A, Vasconcelos AG,
Neves FS, Correa H. Affective temperaments and
antidepressant response in the clinical management
of mood disorders J Affect Disord 2014; 155:138–
41.
- 15. Kesebir A, Gundogar D, Kucuksubas Y,
Tatlıdil Yaylacı E. The relation between affective
temperament and resilience in depression: A
controlled study. J Affect Disord 2013; 148:352–6.
- 16. Park C, An SK, Kim HW, Koh MJ,
Namkoong K, Kang JI. Relationships between
chronotypes and affective temperaments in healthy
young adults. J Affect Disord 2015;175:256–9.
- 17. Shahini M, Shala M, Xhylani P, Gashi S,
Borinca I, Erfurth A. Challenging predictions
between affective temperaments, depression and anxiety in a Kosovo student community sample. Int
J Psychiatry Clin Pract 2018:26:1-7.
- 18. Rotterdam ESHRE/ASRM-Sponsored
PCOS Consensus Workshop Group. Revised 2003
consensus on diagnostic criteria and long-term
health risks related to polycystic ovary syndrome
(PCOS). Hum Reprod 2004;19:41–7.
- 19. Legro RS, Arslanian SA, Ehrmann DA,
Hoeger KM, Murad MH, Pasquali R. Diagnosis and
treatment of polycystic ovary syndrome: an
endocrine society clinical practice guideline. J Clin
Endocrinol Metab 2013;98:4565–92.
- 20. Ferriman D, Gallwey JD Clinical
assessment of body hair growth in women. J Clin
Endocrinol Metab 1961;21:1440–7.
- 21. Kerchner A, Lester W, Stuart SP, Dokras
A. Risk of depression and other mental health
disorders in women with polycystic ovary
syndrome: a longitudinal study. Fertil Steril
2009;91:207–12.
- 22. Tan J, Wang QY, Feng GM, Li XY, Huang
W. Increased Risk of Psychiatric Disorders in
Women with Polycystic Ovary Syndrome in
Southwest China. Chin Med J. 2017; 5;130(3):262-
6.
- 23. Annagür BB, Kerimoglu ÖS, Tazegül A,
Gündüz Ş, Gençoglu BB. Psychiatric comorbidity
in women with polycystic ovary syndrome. J Obstet
Gynaecol Res 2015; 41(8):1229-33.
- 24. Asik M, Altinbas K, Eroglu M, Karaahmet
E, Erbag G, Ertekin HEvaluation of affective
temperament and anxiety-depression levels of
patients with polycystic ovary syndrome. J Affect
Disord 2015 1;185:214-8
- 25. Khazaie H, Ghadami MR, Khaledi-Paveh
B, Chehri A, Nasouri M. Sleep Quality in
University Students with Premenstrual Dysphoric
Disorder. Shanghai Arch Psychiatry 2016;
28(3):131-3.
- 26. Rubinow DR, Schmidt PJ. Gonadal steroid
regulation of mood: The lessons of premenstrual
syndrome. Front Neuroendocrinol 2006; 27
(2):210–6.
- 27. Freeman EW, Halbreich U, Grubb GS. An
overview of four studies of a continuous oral
contraceptive (levonorgestrel 90 mcg/ethinyl
estradiol 20 mcg) on premenstrual dysphoric
disorder and premenstrual syndrome. Contraception
2012;85(5):437-45.
- 28. Sveindottir H, Backstrom T. Prevalence of
menstrual cycle symptom cyclicity and
premenstrual dysphoric disorder in a random
sample of women using and not using oral
contraceptives. Acta Obstet Gynecol Scand
2000;79(5):405-13.
- 29. Hollinrake E, Abreu A, Maifeld M, Van
Voorhis BJ, Dokras A. Increased risk of depressive
disorders in women with polycystic ovary
syndrome. Fertil Steril 2007;87(6):1369-76.
- 30. Blay SL, Aguiar JV, Passos IC. Polycystic
ovary syndrome and mental disorders: a systematic
review and exploratory meta-analysis.
Neuropsychiatr Dis Treat 2016;12:2895-903.