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      Ansiedad y depresión en mujeres con el síndrome de ovario poliquístico Translated title: Anxiety and depression in women with polycystic ovary syndrome

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          Abstract

          RESUMEN Introducción: El síndrome de ovario poliquístico es una condición muy frecuente en la mujer durante la etapa fértil y tiene implicaciones en la esfera reproductiva y cardiometabólica. Sin embargo, se ha observado que estas mujeres también pueden ver afectada su esfera psicoafectiva. Objetivo: Demostrar que las mujeres con síndrome de ovario poliquístico tienen mayor frecuencia de padecer alteraciones del ánimo (ansiedad y depresión). Métodos: Con la metodología de la investigación documental se analizaron 54 artículos publicados desde 2002, procedentes de las bases de PubMed/MEDLINE, Embase, PsycINFO and Web. Se usaron como palabras clave: síndrome de ovario poliquístico, ansiedad, depresión, alteraciones psicológicas y alteraciones psicoafectivas. Conclusiones: Los resultados de las investigaciones revisadas coinciden en que las mujeres con síndrome de ovario poliquístico tienen niveles más latos de depresión y ansiedad que las mujeres sin el síndrome, lo cual se basa en mecanismos biológicos y socioculturales.

          Translated abstract

          ABSTRACT Introduction: Polycystic ovary syndrome is a very frequent condition in women during the fertile stage and has reproductive and cardiometabolic implications. However, it has been observed that these women may also be affected in their psychoaffective sphere. Objective: To demonstrate that women with polycystic ovary syndrome have a higher frequency of mood disorders (anxiety and depression). Methods: Using documentary research methodology, 54 articles published since 2002 were analyzed from PubMed/MEDLINE, Embase, PsycINFO and Web databases. Polycystic ovary syndrome, anxiety, depression, psychological alterations and psychoaffective alterations were used as keywords. Conclusions: The results of the reviewed research coincide in demonstrating that women with PCOS have lower levels of depression and anxiety than women without the syndrome which is based on biological and sociocultural mechanisms.

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          Most cited references42

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          Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies.

          Association between obesity and depression has repeatedly been established. For treatment and prevention purposes, it is important to acquire more insight into their longitudinal interaction. To conduct a systematic review and meta-analysis on the longitudinal relationship between depression, overweight, and obesity and to identify possible influencing factors. Studies were found using PubMed, PsycINFO, and EMBASE databases and selected on several criteria. Studies examining the longitudinal bidirectional relation between depression and overweight (body mass index 25-29.99) or obesity (body mass index > or =30) were selected. Unadjusted and adjusted odds ratios (ORs) were extracted or provided by the authors. Overall, unadjusted ORs were calculated and subgroup analyses were performed for the 15 included studies (N = 58 745) to estimate the effect of possible moderators (sex, age, depression severity). Obesity at baseline increased the risk of onset of depression at follow-up (unadjusted OR, 1.55; 95% confidence interval [CI], 1.22-1.98; P or =60 years) but not among younger persons (aged <20 years). Baseline depression (symptoms and disorder) was not predictive of overweight over time. However, depression increased the odds for developing obesity (OR, 1.58; 95% CI, 1.33-1.87; P < .001). Subgroup analyses did not reveal specific moderators of the association. This meta-analysis confirms a reciprocal link between depression and obesity. Obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression. In addition, depression was found to be predictive of developing obesity.
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            Obesity and neuroinflammation: a pathway to cognitive impairment.

            Obesity is a growing problem worldwide and is associated with a range of comorbidities, including cognitive dysfunction. In this review we will address the evidence that obesity and high fat feeding can lead to cognitive dysfunction. We will also examine the idea that obesity-associated systemic inflammation leads to inflammation within the brain, particularly the hypothalamus, and that this is partially responsible for these negative cognitive outcomes. Thus, obesity, and high fat feeding, lead to systemic inflammation and excess circulating free fatty acids. Circulating cytokines, free fatty acids and immune cells reach the brain at the level of the hypothalamus and initiate local inflammation, including microglial proliferation. This local inflammation likely causes synaptic remodeling and neurodegeneration within the hypothalamus, altering internal hypothalamic circuitry and hypothalamic outputs to other brain regions. The result is disruption to cognitive function mediated by regions such as hippocampus, amygdala, and reward-processing centers. Central inflammation is also likely to affect these regions directly. Thus, central inflammation in obesity leads not just to disruption of hypothalamic satiety signals and perpetuation of overeating, but also to negative outcomes on cognition. Copyright © 2014 Elsevier Inc. All rights reserved.
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              Obesity and the polycystic ovary syndrome.

              The polycystic ovary syndrome (PCOS) is a condition characterized by hyperandrogenism and chronic oligo-anovulation. However, many features of the metabolic syndrome are inconsistently present in the majority of women with PCOS. Approximately 50% of PCOS women are overweight or obese and most of them have the abdominal phenotype. Obesity may play a pathogenetic role in the development of the syndrome in susceptible individuals. In fact, insulin possesses true gonadotrophic function and an increased insulin availability at the level of ovarian tissue may favour excess androgen synthesis. Obesity, particularly the abdominal phenotype, may be partly responsible for insulin resistance and associated hyperinsulinemia in women with PCOS. Therefore, obesity-related hyperinsulinemia may play a key role in favouring hyperandrogenism in these women. Other factors such as increased estrogen production rate, increased activity of the opioid system and of the hypothalamic-pituitary-adrenal axis, decreased sex hormone binding globulin synthesis and, possibly, high dietary lipid intake, may be additional mechanisms by which obesity favours the development of hyperandrogenism in PCOS. Irrespective of the pathogenetic mechanism involved, obese PCOS women have more severe hyperandrogenism and related clinical features (such as hirsutism, menstrual abnormalities and anovulation) than normal-weight PCOS women. This picture tends to be more pronounced in obese PCOS women with the abdominal phenotype. Body weight loss is associated with beneficial effects on hormones, metabolism and clinical features. A further clinical and endocrinological improvement can also be achieved by adding insulin-sensitizing agents and/or antiandrogens to weight reduction programmes. These obviously emphasize the role of obesity in the pathophysiology of PCOS.
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                Author and article information

                Journal
                end
                Revista Cubana de Endocrinología
                Rev Cubana Endocrinol
                Editorial Ciencias Médicas (Ciudad de la Habana, , Cuba )
                1561-2953
                August 2022
                : 33
                : 2
                : e305
                Affiliations
                [1] La Habana orgnameUniversidad de Ciencias Médicas de La Habana orgdiv1Instituto Nacional de Endocrinología (INEN) Cuba
                Article
                S1561-29532022000200002 S1561-2953(22)03300200002
                3ca88c82-7428-4231-88b3-d7648ef0b861

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 24 March 2021
                : 22 October 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 0
                Product

                SciELO Cuba

                Categories
                ARTÍCULO DE REVISIÓN

                ansiedad,polycystic ovary syndrome,depression,anxiety,psychoaffective disorder.,síndrome de ovario poliquístico,depresión,trastorno psicoafectivo

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