负性情绪对多囊卵巢综合征不孕症的影响

doi:10.12280/gjfckx.20230144

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovarian syndrome，PCOS）是育龄期女性常见的生殖内分泌疾病之一，受中国传统文化、生育观念、社会、经济、家庭及疾病本身等因素影响，PCOS不孕症患者常存在心理调节功能受损，表现出更明显的抑郁、焦虑等负性情绪特征。负性情绪与疾病互为因果，互相影响，形成恶性循环，影响或加重PCOS患者的临床特征、性激素水平和糖脂代谢紊乱情况，进而导致不孕的发生，并对妊娠结局造成不良影响。积极的心理干预及治疗可以改善患者的心理状态，消除或缓解焦虑等负性情绪，从而改善PCOS不孕症的治疗结局。对以上方面进行综述，以期为PCOS不孕症患者的临床治疗提供新思路。

关键词: 情绪, 焦虑, 抑郁, 多囊卵巢综合征, 不育, 女（雌）性, 心理社会干预, 负性情绪

Abstract:

Polycystic ovary syndrome (PCOS) is one of the most common reproductive endocrine disease in women of reproductive age. It is affected by traditional Chinese culture, fertility concepts, social, economic, family and the disease, PCOS infertility patients often have impaired psychological regulation function, showing more obvious negative emotional characteristics such as depression and anxiety. Negative emotion and disease are causal to each other, they influence each other and form a vicious circle, affecting or aggravating the clinical features, sex hormone level and disorder of glucose and lipid metabolism of PCOS patients, which in turn leads to the occurrence of infertility, and the adverse effects of pregnancy outcomes. The positive psychological intervention and treatment can improve the patients′ psychological state, eliminate or alleviate the negative emotions such as anxiety, thus improve the treatment outcome of PCOS infertility. This article summarizing from the above aspects, is expected to provide new ideas for clinical treatment of patients with PCOS infertility.

Key words: Emotions, Anxiety, Depression, Polycystic ovary syndrome, Infertility, female, Psychosocial intervention, Negative emotion

寇丽辉, 宋殿荣, 郭洁. 负性情绪对多囊卵巢综合征不孕症的影响[J]. 国际妇产科学杂志, 2023, 50(5): 535-539.

KOU Li-hui, SONG Dian-rong, GUO Jie. Effects of Negative Emotion on Infertility Patients with Polycystic Ovary Syndrome[J]. Journal of International Obstetrics and Gynecology, 2023, 50(5): 535-539.

参考文献 30

[1]	Lin H, Liu M, Zhong D, et al. The Prevalence and Factors Associated With Anxiety-Like and Depression-Like Behaviors in Women With Polycystic Ovary Syndrome[J]. Front Psychiatry, 2021, 12:709674. doi: 10.3389/fpsyt.2021.709674.
[2]	Basirat Z, Faramarzi M, Esmaelzadeh S, et al. Stress, Depression, Sexual Function, and Alexithymia in Infertile Females with and without Polycystic Ovary Syndrome: A Case-Control Study[J]. Int J Fertil Steril, 2019, 13(3):203-208. doi: 10.22074/ijfs.2019.5703. pmid: 31310074
[3]	Basirat Z, Faramarzi M, Chehrazi M, et al. Differences between infertile women with and without PCOS in terms of anxiety, coping styles, personality traits, and social adjustment: a case-control study[J]. Arch Gynecol Obstet, 2020, 301(2):619-626. doi: 10.1007/s00404-019-05391-7. pmid: 31776708
[4]	Ahmadi M, Faramarzi M, Basirat Z, et al. Mental and personality disorders in infertile women with polycystic ovary: a case-control study[J]. Afr Health Sci, 2020, 20(3):1241-1249. doi: 10.4314/ahs.v20i3.28. pmid: 33402971
[5]	Naumova I, Castelo-Branco C, Casals G. Psychological Issues and Sexual Function in Women with Different Infertility Causes: Focus on Polycystic Ovary Syndrome[J]. Reprod Sci, 2021, 28(10):2830-2838. doi: 10.1007/s43032-021-00546-x. pmid: 33763818
[6]	Aguiar-Bloemer AC, Palazzo CC, Diez-Garcia RW. Relationship of negative emotion with leptin and food intake amongoverweight women[J]. Physiol Behav, 2021, 237:113457. doi: 10.1016/j.physbeh.2021.113457.
[7]	Mannan M, Mamun A, et al. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies[J]. PLoS One, 2016,11(6):e0157240. doi: 10.1371/journal.pone.0157240.
[8]	Wen X, Han Z, Liu SJ, et al. Phycocyanin Improves Reproductive Ability in Obese Female Mice by Restoring Ovary and Oocyte Quality[J]. Front Cell Dev Biol, 2020, 8:595373. doi: 10.3389/fcell.2020.595373.
[9]	Liu S, Hong L, Lian R, et al. Transcriptomic Analysis Reveals Endometrial Dynamics in Normoweight and Overweight/Obese Polycystic Ovary Syndrome Women[J]. Front Genet, 2022, 13:874487. doi: 10.3389/fgene.2022.874487.
[10]	Cooney LG, Lee I, Sammel MD, et al. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis[J]. Hum Reprod, 2017, 32(5):1075-1091. doi: 10.1093/humrep/dex044.
[11]	Mehrabadi S, Sadatmahalleh SJ, Kazemnejad A, et al. Association of acne, hirsutism, androgen, anxiety, and depression on cognitive performance in polycystic ovary syndrome: A cross-sectional study[J]. Int J Reprod Biomed, 2020, 18(12):1049-1058. doi: 10.18502/ijrm.v18i12.8026. pmid: 33426415
[12]	Klimczak D, Szlendak-Sauer K, Radowicki S. Depression in relation to biochemical parameters and age in women with polycystic ovary syndrome[J]. Eur J Obstet Gynecol Reprod Biol, 2015, 184:43-47. doi: 10.1016/j.ejogrb.2014.10.028. pmid: 25463634
[13]	Özdil Demiryürek E, Tekin A, Çakmak E, et al. Correlations between impulsiveness and biochemical parameters in women with polycystic ovary syndrome[J]. Eur J Obstet Gynecol Reprod Biol, 2016, 207:5-10. doi: 10.1016/j.ejogrb.2016.09.002. pmid: 27770705
[14]	Annagür BB, Tazegül A, Uguz F, et al. Biological correlates of major depression and generalized anxiety disorder in women with polycystic ovary syndrome[J]. J Psychosom Res, 2013, 74(3):244-247. doi: 10.1016/j.jpsychores.2013.01.002. pmid: 23438716
[15]	Gong H, Wu W, Xu J, et al. Flutamide ameliorates uterine decidualization and angiogenesis in the mouse hyperandrogenemia model during mid-pregnancy[J]. PLoS One, 2019, 14(5):e0217095. doi: 10.1371/journal.pone.0217095.
[16]	Semeniuk LM, Likhachov VK, Yuzvenko TY, et al. Risk markers of reproductive loss in women with hyperandrogenism[J]. Wiad Lek, 2018, 71(8):1550-1553. pmid: 30684339
[17]	Schliep KC, Mumford SL, Vladutiu CJ, et al. Perceived stress, reproductive hormones, and ovulatory function: a prospective cohort study[J]. Epidemiology, 2015, 26(2):177-184. doi: 10.1097/EDE.0000000000000238. pmid: 25643098
[18]	Zhang D, Gao J, Qin H, et al. Phenotypic features and fertility outcomes of women with polycystic ovary syndrome: The effect of quality of life[J]. J Obstet Gynaecol Res,2020 Oct 14. doi: 10.1111/jog.14478.
[19]	Tian JS, Qin PF, Xu T, et al. Chaigui granule exerts anti-depressant effects by regulating the synthesis of Estradiol and the downstream of CYP19A1-E2-ERKs signaling pathway in CUMS-induced depressed rats[J]. Front Pharmacol, 2022, 13:1005438. doi: 10.3389/fphar.2022.1005438.
[20]	Schliep KC, Mumford SL, Silver RM, et al. Preconception Perceived Stress Is Associated with Reproductive Hormone Levels and Longer Time to Pregnancy[J]. Epidemiology, 2019, 30(Suppl 2):S76-S84. doi: 10.1097/EDE.0000000000001079.
[21]	Lee JH, Park SK, Ryoo JH, et al. The association between insulin resistance and depression in the Korean general population[J]. J Affect Disord, 2017, 208:553-559. doi: 10.1016/j.jad.2016.10.027.
[22]	Greenwood EA, Pasch LA, Cedars MI, et al. Insulin resistance is associated with depression risk in polycystic ovary syndrome[J]. Fertil Steril, 2018, 110(1):27-34. doi: 10.1016/j.fertnstert.2018.03.009. pmid: 29908775
[23]	Zhang Y, Hu M, Jia W, et al. Hyperandrogenism and insulin resistance modulate gravid uterine and placental ferroptosis in PCOS-like rats[J]. J Endocrinol, 2020, 246(3):247-263. doi: 10.1530/JOE-20-0155. pmid: 32590339
[24]	Zhang M, Chen J, Yin Z, et al. The association between depression and metabolic syndrome and its components: a bidirectional two-sample Mendelian randomization study[J]. Transl Psychiatry, 2021, 11(1):633. doi: 10.1038/s41398-021-01759-z.
[25]	Kim GU, Kim N, Kim H. Association between self-reported medical diagnosis of depression and metabolic syndrome in a population-based study: A propensity score-matched analysis[J]. Nurs Open, 2022, 9(1):367-376. doi: 10.1002/nop2.1074.
[26]	Purewal S, Chapman S, van den Akker O. Depression and state anxiety scores during assisted reproductive treatment are associated with outcome: a meta-analysis[J]. Reprod Biomed Online, 2018, 36(6):646-657. doi: 10.1016/j.rbmo.2018.03.010. pmid: 29622404
[27]	Aimagambetova G, Issanov A, Terzic S, et al. The effect of psychological distress on IVF outcomes: Reality or speculations?[J]. PLoS One, 2020, 15(12):e0242024. doi: 10.1371/journal.pone.0242024.
[28]	Teede HJ, Misso ML, Costello MF, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome[J]. Hum Reprod, 2018, 89(3):251-268. doi: 10.1111/cen.13795.
[29]	Gaitzsch H, Benard J, Hugon-Rodin J, et al. The effect of mind-body interventions on psychological and pregnancy outcomes in infertile women: a systematic review[J]. Arch Womens Ment Health, 2020, 23(4):479-491. doi: 10.1007/s00737-019-01009-8. pmid: 31897607
[30]	Tang R, Yang J, Yu Y, et al. The effects of cognitive behavioral therapy in women with polycystic ovary syndrome: A meta-analysis[J]. Front Psychol, 2022, 13:796594. doi: 10.3389/fpsyg.2022.796594.