Balikci Adem, Erdem Murat, Keskin Uğur, Bozkurt Zincir Selma, Gülsün Murat, Özçelik Fatih, Akgül Emin Özgür, Akarsu Süleyman, Öztosun Muzaffer, Ergün Ali
Gülhane Military Medical Academy, Department of Psychiatry, Ankara, Turkey.
Gülhane Military Medical Academy, Department of Obstetrics and Gynaecology, Ankara, Turkey.
Noro Psikiyatr Ars. 2014 Dec;51(4):328-333. doi: 10.5152/npa.2014.6898. Epub 2014 Dec 1.
Polycystic Ovary Syndrome (PCOS) is a syndrome of heterogeneous nature, affecting multiple systems, particularly the endocrine system. We propose to investigate the possible relationships among hormonal changes, levels of anxiety, depression, and anger in patients with PCOS.
Forty-four female patients with PCOS and 44 body mass index (BMI )-matched healthy women participated in this study. We measured the sociodemographic features, some serum hormonal levels (insulin, gonadotropins, prolactin, dehydroepiandrosterone sulfate (DHEAS), thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), 17 OH-progesterone, and total and free testosterone), and some other biochemical parameters of the participants. Also, all participants completed the Trait Anger-Anger Expression Scale (STAS), Beck Depression, and Beck Anxiety Inventories. We evaluated the psychiatric scale scores obtained from PCOS patients and control subjects. We used the independent-samples t-test for parametric data to evaluate normal distribution, and Mann-Whitney U-test was used for both abnormally distributed and nonparametric data. We used Pearson correlation analysis to evaluate the potential connection between the two groups' data.
The mean ages of the patients with PCOS and control subjects who participated in this study were 27.3±5.6 and 27.4±6.1 years, respectively. The measures of BMI, insulin, luteinizing hormone (LH), DHEAS, and total testosterone serum levels in the patient group were significantly higher than in the control group (p<.05). There was a statistically significant positive correlation between Beck anxiety scores and serum DHEAS levels (Pearson r=.4366, P=.0001). We found significant differences between the two groups in terms of trait anger, anger control, outward and inward anger, anxiety level, and depression scores (P<.05).
Anxiety symptoms indicate a stronger relationship compared to depression with DHEAS serum levels via the autonomic nervous system, considering the gamma-aminobutyric acid (GABA)-antagonistic effect of DHEAS. Obesity, hirsutism, and infertility may reduce self-confidence and create depressive symptoms in patients with PCOS. In addition, changes in hormonal levels may lead to anxiety directly. Possibly, depressive symptoms are a secondary reflection of these changes.
多囊卵巢综合征（PCOS）是一种具有异质性的综合征，会影响多个系统，尤其是内分泌系统。我们建议研究PCOS患者激素变化、焦虑、抑郁和愤怒水平之间的可能关系。
44名患有PCOS的女性患者和44名身体质量指数（BMI）匹配的健康女性参与了本研究。我们测量了参与者的社会人口学特征、一些血清激素水平（胰岛素、促性腺激素、催乳素、硫酸脱氢表雄酮（DHEAS）、促甲状腺激素（TSH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、17-羟孕酮以及总睾酮和游离睾酮）以及一些其他生化参数。此外，所有参与者都完成了特质愤怒-愤怒表达量表（STAS）、贝克抑郁量表和贝克焦虑量表。我们评估了从PCOS患者和对照组获得的精神量表分数。对于参数数据，我们使用独立样本t检验来评估正态分布，对于异常分布和非参数数据则使用曼-惠特尼U检验。我们使用皮尔逊相关分析来评估两组数据之间潜在的联系。
参与本研究的PCOS患者和对照组的平均年龄分别为27.3±5.6岁和27.4±6.1岁。患者组的BMI、胰岛素、黄体生成素（LH）、DHEAS和总睾酮血清水平的测量值显著高于对照组（p<.05）。贝克焦虑量表得分与血清DHEAS水平之间存在统计学上显著的正相关（皮尔逊r=.4366，P=.0001）。我们发现两组在特质愤怒、愤怒控制、外向和内向愤怒、焦虑水平和抑郁得分方面存在显著差异（P<.05）。
考虑到DHEAS的γ-氨基丁酸（GABA）拮抗作用，通过自主神经系统，焦虑症状与DHEAS血清水平的关系比抑郁更为密切。肥胖、多毛症和不孕症可能会降低PCOS患者的自信心并产生抑郁症状。此外，激素水平的变化可能直接导致焦虑。抑郁症状可能是这些变化的继发反映。
