Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Eur J Endocrinol. 2020 Jul;183(1):1-11. doi: 10.1530/EJE-20-0066.
Little is known about how lifestyle affects psychological well-being in overweight women with polycystic ovary syndrome (PCOS). We investigated the effects of behavioral modification on psychological well-being and the impact of well-being and personality traits on successful weight loss.
A 4-month randomized controlled trial with a 12-month follow-up at a University Hospital.
Sixty-eight women with PCOS, aged 18 to 40 years with a BMI ≥27 kg/m2, were randomized (1:1) into a behavioral modification program (intervention) or minimal intervention (control). The outcome measures were the psychological well being index and the Swedish universities scales of personality.
At baseline, 60% had a global psychological well being index corresponding to severe distress and 40% to moderate distress. There was no significant change in mean global well-being score at 4 months within or between groups. However, after 4 months, the intervention group expressed less anxiety (P = .035), higher general health (P = .012) and lower depressed mood (P = .033). Anxiety and general health tended to differ between groups (P = .06, respectively) favoring intervention. In the whole population, women achieving ≥5% weight loss at 12 months (n = 18) were less anxious at baseline compared to those who had not (P = .004). Personality trait-analysis showed that the weight-loss group had higher social desirability (P = .033) and lower embitterment (P = .023).
Psychological well-being is severely impacted in overweight women with PCOS. Behavioral modification can positively impact dimensions of well-being, although not fully significant, compared to control treatment. Personality factors could contribute to the understanding of successful weight loss.
多囊卵巢综合征(PCOS)患者体质量超重,生活方式对其心理健康的影响鲜为人知。本研究旨在探讨行为修正对心理健康的影响,以及心理健康和人格特质对成功减肥的影响。
在一所大学医院进行的 4 个月随机对照试验,随访 12 个月。
68 名年龄 18 至 40 岁、BMI≥27kg/m2 的 PCOS 患者,按 1:1 随机分为行为修正方案(干预组)或最低限度干预(对照组)。主要结局指标为心理幸福感指数和瑞典大学人格量表。
基线时,60%的患者心理幸福感指数总体评分严重抑郁,40%中度抑郁。4 个月内或组间平均总体幸福感评分无显著变化。然而,干预组的焦虑评分(P=0.035)、一般健康评分(P=0.012)和抑郁评分(P=0.033)均低于对照组。焦虑和一般健康评分在组间也存在差异(P=0.06 和 0.01,分别有利于干预组)。在全人群中,12 个月时体重减轻≥5%(n=18)的患者,与未减轻的患者相比,基线时焦虑评分较低(P=0.004)。人格特质分析显示,体重减轻组的社会期望度较高(P=0.033),痛苦感较低(P=0.023)。
超重的 PCOS 患者心理幸福感严重受损。与对照组相比,行为修正虽然未完全显著,但可对幸福感的某些维度产生积极影响。人格因素可能有助于理解成功减肥的原因。