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多囊卵巢综合征女性抑郁症状的临床病程和持续抑郁风险的预测因素:一项纵向研究的结果。

Clinical course of depression symptoms and predictors of enduring depression risk in women with polycystic ovary syndrome: Results of a longitudinal study.

机构信息

Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, California.

Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, California.

出版信息

Fertil Steril. 2019 Jan;111(1):147-156. doi: 10.1016/j.fertnstert.2018.10.004. Epub 2018 Nov 17.

Abstract

OBJECTIVE

To [1] characterize depression symptoms over time and [2] test the hypothesis that adverse metabolic parameters would associate with risk of enduring depression risk in women with polycystic ovary syndrome (PCOS).

DESIGN

Prospective cohort study.

SETTING

University center.

PATIENT(S): One hundred sixty-three women with PCOS.

INTERVENTION(S): The Beck Depression Inventory Fast Screen (BDI-FS) was self-administered at baseline and follow-up to identify depression risk, using a cutoff score >4.

MAIN OUTCOME MEASURE(S): BDI-FS scores.

RESULT(S): Median baseline age was 29.0 years, and median follow-up interval was 5.5 years. Fifty-nine of 163 women had positive depression screens at baseline (36%); 52 women (32%) screened positive at follow-up. Median change in BDI-II score was 0 (interquartile range, -2, 1) over the study period. Of the 59 women at risk for depression at baseline, 22 screened negative at follow-up (37%), while 37 women remained at risk (63%). Considering these 59 women with positive depression screens at baseline, higher body mass index (BMI) was associated with increased odds of enduring depression risk at follow-up (adjusted odds ratio = 1.09; 95% confidence interval, 1.00, 1.18), in a multivariate logistic regression model. Compared with women with normal body weight at baseline, obese women (BMI >30 kg/m) had five-fold increased odds of enduring depression risk at follow-up (adjusted odds ratio = 5.07; 95% confidence interval, 1.07, 24.0).

CONCLUSION(S): The prevalence of depression was relatively stable over time in a cohort of women with PCOS. Elevated BMI is a hallmark of enduring depression risk. These results may assist providers in developing targeted intervention strategies to reduce the prevalence of long-term depressive symptoms in women with PCOS.

摘要

目的

[1]描述多囊卵巢综合征(PCOS)女性随时间推移的抑郁症状特征,[2]检验代谢不良参数与持续性抑郁风险相关的假设。

设计

前瞻性队列研究。

地点

大学中心。

患者

163 名 PCOS 女性。

干预措施

基线和随访时,患者使用贝克抑郁量表快速筛查版(BDI-FS)进行自我评估,以 4 分作为截断值,确定抑郁风险。

主要观察指标

BDI-FS 评分。

结果

中位基线年龄为 29.0 岁,中位随访间隔为 5.5 年。163 名女性中,59 名(36%)基线时抑郁筛查阳性,52 名(32%)随访时阳性。研究期间,BDI-II 评分中位数变化为 0(四分位距,-2,1)。59 名基线时处于抑郁风险中的女性中,22 名(37%)在随访时转为阴性,37 名(63%)仍处于风险中。考虑这些基线时抑郁筛查阳性的 59 名女性,较高的体重指数(BMI)与随访时持续性抑郁风险增加相关(调整后的优势比=1.09;95%置信区间,1.00,1.18),在多变量逻辑回归模型中。与基线时体重正常的女性相比,肥胖女性(BMI>30kg/m)在随访时持续性抑郁风险增加 5 倍(调整后的优势比=5.07;95%置信区间,1.07,24.0)。

结论

在 PCOS 女性队列中,抑郁的流行率随时间相对稳定。BMI 升高是持续性抑郁风险的标志。这些结果可能有助于提供者制定针对性的干预策略,以降低 PCOS 女性长期抑郁症状的发生率。

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