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Pcos and anxiety..The vast majority of the scientific literature on polycystic ovary syndrome (PCOS) has used a bio-medical approach to analyze this disease. In Latin America, and specifically in the Spanish language, there is little information about the relationship between PCOS and psychological factors.

Objective : To analyze this gynecological disorder of endocrine origin and its association with different psychological factors, as well as its integral approach. Method : A database search was conducted in recent years with the terms “SOP”, “quality of life”, “anxiety”, “depression“, “body image” and “sexual dysfunction”.

pcos and anxiety

pcos and anxiety

Results: PCOS is a multifactorial disease that has been linked to depression, anxiety, stress, dissatisfaction with body image, sexual and eating disorders, cognitive functioning, quality of life and psychological well-being; the co-occurrence of this type of psychological situations feeds the somatic condition in mention. Conclusion :

The psychological approach can complement the preventive and therapeutic actions that influence the effectiveness of the treatment and the subjective well-being reported by the patients.

 

SUMMARY

Background : The vast majority of the scientific literature on polycystic ovary syndrome (PCOS) have used a bio-medical approach to analyzing this disease. In Latin America, specifically in Spanish, little is known about the relationship of PCOS with psychological factors. Aim :

To analyze this gynecological disorder of endocrine origin and their association with different psychological factors and their comprehensive approach. Method : A search was performed on databases in recent years with the terms “PCOS”, “quality of life”, “anxiety”, “depression”, “body image” and “sexual dysfunction.

” Results: PCOS is a multifactorial disease that has been linked to depression, anxiety, stress, dissatisfaction with body image, sexual and eating disorders, cognitive functioning, quality of life and psychological well-being; The co-occurrence of such psychological situations feed the somatic condition analyzed. Conclusion : The psychological approach can complement the preventive and therapeutic actions that influence the effectiveness of treatment and subjective well-being reported by patients.

INTRODUCTION

Polycystic ovary syndrome (PCOS) has become a serious public health problem, being the most common of the endocrine disorders in women of reproductive age (1), with a ratio of one in five people in this population (2). ).

It is a disease of multifactorial etiology, comorbid in many cases with obesity, dyslipidemia, cardiovascular disorders, endometrial hyperplasia, disorders of the menstrual period and infertility (3), endometrial cancer (4), breast cancer (5). ), and pro-inflammatory processes (6); this condition, in turn, affects tolerance to glucose metabolism (7), insulin resistance and potentiates hyperandrogenism (1).

These somatic symptoms tend to precipitate psychological problems among which are stress, anxiety, depression, decreased quality of life, changes in body image and identity, low self-esteem, and psycho-sexual dysfunctions (8), as well as the execution of unhealthy practices compared, for example, with diabetic patients (9);

Moreover, such affectations are not only related to the disease itself, but also to fears of metabolic and cardiac risks and infertility (1,10). However, despite all the above, the assessment, diagnosis and treatment of the psychological conditions associated with PCOS are still quite discrete (10), particularly in Spanish-speaking contexts.

The objective of this research is to present a systematic review of both the documented empirical evidence regarding the psychological factors that have been shown as being associated with the SOP, and its integral approach.

MATERIAL AND METHOD

With the methodology of documentary research, 54 articles published since 2002, from the databases MedLine, PsyArticles, Proquest, ScienceDirect and SpringerJournal are addressed. The terms “polycystic ovary syndrome”, “quality of life”, “anxiety”, “depression”, “body image” and “sexual dysfunctions” were used as key words.

RESULTS

Stress. Stress is often identified in young women with PCOS, which is indirectly promoted by the increase of testosterone via hypothalamic-pituitary-adrenal (HPA) (12,13), contributing to the presence of hirsutism and other implications.

aesthetics (14); This significantly reduces female identity, and in this way, it is fed back into the form of psychological distress (15), and sexual dysfunctions (16,17,18). Likewise, stress negatively compromises the regularity of the menstrual cycle and ovulation, affecting strong endocrine and emotional changes (16).

When compared with control subjects, patients with sOp have greater activity of plasma ACTH and corticosteroids due to overexposure to induced stressors (11). It should not be forgotten that cortisol produced during periods of chronic distress induces, through epigenetic mechanisms, the increased cardiovascular risk and myocardial infarction (11), reported from the increase in systolic and diastolic pressure, as well as the activation exacerbated by pro-inflammatory cytokines (19).

The latter, together with stress, potentiate behavioral changes related to anhedonia, fatigue, delayed movements, eating disorders, social isolation, sleep disorders and cognitive distortions, which in turn have greater vulnerability to depressive states, and increasing sensitivity to pain.

Furthermore, once the pro-inflammatory cytokines cross the blood-brain barrier, they produce alterations in the synthesis of serotonin and norepinephrine, which are key in the development of depressive states (9).

Patients with PCOS tend to have a hyperresponsive HPA axis in the face of threatening events, which can be associated with a greater predisposition to pathologies such as depression, cardiovascular risks and type II diabetes (11), in turn related to unhealthy behaviors, the impairment of adherence to treatments, greater predisposition to obesity and insulin resistance, as well as the increase of chronic inflammation (11).

Body self-image. The body self-image corresponds to the relationship between the silhouette and the meanings culturally granted to be healthy, attractive and suitable for reproduction (11).

The perception of beauty and physical attractiveness in Western cultures is based on thin models, being different from the canons established by Oriental peoples, in which even overweight is perceived as a sign of prosperity and aesthetics (11).

Within each culture, men and women look for their image to correspond to the imposed standards, and when this does not happen, difficulties arise in self-image and self-esteem, which, in turn, have a negative impact on their overall health (20), as it becomes a stressful condition, which encourages the adoption of risky practices, particularly by younger patients,

The ambivalences that emerge with the identification of gender, associated with the age and severity of the clinical manifestations, are of considerable concern, which creates a conflict with the culturally imposed feminine schemes, and enhances maladaptive social roles (22).

The changes that appear in body shape also affect the quality of life perceived (23), representing for patients with PCOS a lower satisfaction with their body, and a poor self-image in women who also present hirsutism and overweight (24 , 25).

In fact, women with PCOS indicate that a greater deterioration in quality of life is due more to changes in physical appearance and hirsutism than to metabolic and endocrine changes associated with menstrual irregularity and infertility (26).

On the other hand, in contrast to the control group, patients with PCOS are attributed greater self-blame and impotence, as well as less acceptance of the disease, which translates into difficulties to adequately address the stressful challenges to which they are exposed, since in turn, it increases the risk of developing future psychosomatic disorders (27).

Other authors (28) also find that women with PCOS present a tendency to neurotic personality traits, more difficulties in the control of anger, and indicate a greater deterioration of their quality of life in relation to women in the control group, registering 70%. % of the patients investigated irritable personality traits (29). Similarly, it is found that patients with PCOS who have a Body Mass Index (BMI) greater than 25 show a lower tolerance to stress (13).

Finally, it is found that women with PCOS without overweight present a strong association between the distorted perception of their body image and the severity of the concomitant depressive disorder (30).

Depression . People with PCOS tend to present with depression, although with considerable heterogeneity between the compared studies (13,31), which include groups with and without anti-androgenic medication, as well as women with a high BMI, the latter being profiled as the factor of most relevant risk in this regard (13). However, the differences in depression manifested by patients and the control

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