青少年多囊卵巢综合征与心理健康

María Rosario Matte, Juan Pablo Del Río, Olga Fernández, Nicolás Crisosto
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摘要

多囊卵巢综合征(PCOS)是女性青少年中最常见的内分泌代谢疾病,它与代谢、心血管和生殖并发症有关。最近的研究结果还表明,受影响的患者及其后代都与精神病理有关。在本次更新中,我们通过系统检索PubMed、Epistemonikos和Scielo上近5年发表的文章,综合了最近关于女性和青少年多囊卵巢综合征心理健康的文献。患有多囊卵巢综合征的女性患焦虑症、抑郁症、饮食失调、强迫症、双相情感障碍和精神病的风险显著增加。此外,还存在神经发育障碍的风险,如自闭症谱系障碍、注意力缺陷和多动障碍,这些都会影响到个人和他们的后代。高胰岛素血症和高雄激素症可以部分解释这些关联,影响中枢神经系统的成熟,特别是在宫内生活和青春期。由疾病的物理表型特征引起的痛苦也会影响患者的心理健康。目前还没有足够的研究来解释这种相关性的起源,也没有专门针对这些患者心理健康的临床试验。目前的证据表明,有必要积极评估这些患者的心理健康状况,并协调参与病理管理的不同卫生团队。
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[Polycystic Ovary Syndrome and Mental Health in Adolescents].

Polycystic Ovary Syndrome (PCOS) is the most common endocrine-metabolic disorder in female adolescents, and it is associated with metabolic, cardiovascular, and reproductive complications. Recent findings also suggest an association with psychiatric pathology, both affected patients and their offspring. In this update, we synthesized the recent literature on mental health in women and adolescents with PCOS through a systematic search in PubMed, Epistemonikos, and Scielo for articles published in the last 5 years. There is a significantly increased risk of anxiety disorders, depression, eating disorders, obsessive-compulsive disorder, bipolar affective disorder, and psychosis in women with PCOS. Additionally, there is a risk of neurodevelopmental disorders, such as autism spectrum disorder and attention deficit and hyperactivity disorder, both affected individuals and their offspring. Hyperinsulinemia and hyperandrogenism could explain part of these associations, affecting the maturation of the central nervous system, especially during intrauterine life and adolescence. Distress due to the physical phenotypic characteristics of the disease could also impact the mental health of patients. There are still not enough studies explaining the origin of this correlation, nor clinical trials that specifically address mental health in these patients. Current evidence suggests the need to actively assess the mental health of these patients and to coordinate the different health teams involved in managing the pathology.

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