Persistent Psychological Distress in Patients Treated for Endocrine Disease

Sonino, Nicoletta; Navarrini, Cecilia; Ruini, Chiara; Ottolini, Fedra; Paoletta, Agostino; Fallo, Francesco; Boscaro, Marco; Fava, Giovanni A.

doi:10.1159/000075538

Cited by 83 publications

(71 citation statements)

References 17 publications

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“…On the other hand, in our data set, correlations between the degree of physical symptoms or endocrine disturbances and psychological distress and/or impairment of well-being were weak. Psychological distress appears to be common in many endocrine disorders (48,49). However, in any one individual, it may not be possible to predict the degree of psychological distress based on the presence or absence of individual symptoms or a specific symptom constellation alone.…”

Section: Discussionmentioning

confidence: 99%

Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome

et al. 2005

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Objective: Polycystic ovary syndrome (PCOS) has been shown to cause a reduction in quality of life. This study examines the extent of different PCOS symptoms on quality-of-life, psychosocial wellbeing and sexual satisfaction. Methods: Complete metabolic, hormonal, clinical and psychosocial data were obtained from a total of 120 women with PCOS. Patients were compared with 50 healthy women to establish reductions in quality-of-life and emotional well-being. In addition, the correlation between psychosocial variables and the major clinical PCOS features obesity (body mass index (BMI)), excessive body hair (hirsutism score), acne, hyperandrogenism (serum testosterone levels), disturbed insulin regulation (area under the insulin response curve and homeostasis model assessment of insulin resistance), menstrual cycle disturbances and infertility were analyzed. Results: PCOS patients showed significant reductions in quality-of-life, increased psychological disturbances, and decreased sexual satisfaction when compared with healthy controls. BMI and hirsutism scores, but not the presence of acne, were associated with physical aspects of quality-of-life and sexual satisfaction. No clear effect of androgens or insulin resistance on psychosocial variables was detected. Similarly, the type of menstrual cycle disturbances or infertility had no impact on psychological well-being. Conclusion: In PCOS, changes in appearance, particularly obesity and hirsutism, reduce physical dimensions of quality-of-life and decrease sexual satisfaction. The role of biochemical, endocrine and metabolic parameters as well as menstrual irregularities and infertility appeared to be less important. Clinicians should pay attention to the psychosocial dimensions of PCOS on an individual basis, regardless of symptom severity or treatment response. 153 853-860 European Journal of Endocrinology

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Section: Discussionmentioning

confidence: 99%

Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome

et al. 2005

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“…17,19,24,25 Sonino and colleagues showed that anxiety disorders in PCOS patients are common and that noticeable impairment of mental function may occur in these patients. 26 These women are at an increased risk of psychological ill health which may markedly reduce their quality of life. [18][19][20][21][22]27,28 Why these women are vulnerable to psychiatric disorders remains unclear; the contributing mechanisms for psychological disorders have not been completely understood, but they likely involve several pathways.…”

confidence: 99%

Psychosocial Factors Associated with Polycystic Ovary Syndrome: a Case Control Study

Sayyah-Melli¹,

Alizadeh²,

Pourafkary³

et al. 2015

J Caring Sci

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Article Type: Original ArticleIntroduction: Polycystic ovary syndrome (PCOS) is a disorder in women of reproductive age. Psychosocial factors can play a role in PCOS. Methods: To determine the psychosocial factors associated with PCOS in a case control study, 742 PCOS cases were compared to 798 women without PCOS for psychiatric disorders and social conditions. The data were collected using a validated questionnaire of the Minnesota Multiphasic Personality Inventory (MMPI). The Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire (DSM-IV) was used to diagnose major psychopathological disorders and other depressive and anxiety syndromes. The suspected psychopathology was evaluated by a clinical psychiatrist. Results: There was a significant difference between cases and controls in education level (71.8% vs. 80.4%; (P<0.001), and employment status (60% vs. 53%; P=0.01) (respectively). Chronic anxiety (35.7% vs. 26.8%; P<0.001), depression (18.9% vs. 7.9 %; P<0.001), anxiety disorders (7.7% vs. 3.3%; P<0.001), and personality disorders (2.9% vs. 1.7%; P=0.01), were higher in the PCOS patients compared controls, respectively. Conclusion:The results showed that chronic anxiety and depression were the most pscycologic pattern in PCO patients. Lower educational level and unemployment were higher in the cases than controls.

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“…The application of the DCPR operational criteria has permitted to document the occurrence of demoralization across different medical settings, substantiating previous findings that used dimensional tools 20, 21 . In studies utilizing the DCPR, demoralization was found in 14-44% of patients with cardiac 22 , oncological 23 , dermatological 24 , gastrointestinal 25 and endocrine conditions [26][27][28] , in those recruited in primary care 29 and in consultation-liaison psychiatry settings 30,31 . Table 1 DCPR criteria for demoralization A through C are required A.…”

Section: Introductionmentioning

confidence: 99%

Subtyping demoralization in the medically ill by cluster analysis

et al. 2013

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ITALY ABSTRACT -Background and Objectives:There is increasing interest in the issue of demoralization, particularly in the setting of medical disease. The aim of this investigation was to use both DSM-IV comorbidity and the Diagnostic Criteria for Psychosomatic Research (DCPR) in order to characterize demoralization in the medically ill.Methods: 1700 patients were recruited from 8 medical centers in the Italian Health System and 1560 agreed to participate. They all underwent a cross-sectional assessment with DSM-IV and DCPR structured interviews. 373 patients (23.9%) received a diagnosis of demoralization. Data were submitted to cluster analysis.Results: Four clusters were identified: demoralization and comorbid depression; demoralization and comorbid somatoform/adjustment disorders; demoralization and comorbid anxiety; demoralization without any comorbid DSM disorder. The first cluster included 27.6% of the total sample and was characterized by the presence of DSM-IV mood disorders (mainly major depressive disorder). The second cluster had 18.2% of the cases and contained both DSM-IV somatoform (particularly, undifferentiated somatoform disorder and hypochondriasis) and adjustment disorders. In the third cluster (24.7%), DSM-IV anxiety disorders in comorbidity with demoralization were predominant (particularly, generalized anxiety disorder, agoraphobia, panic disorder and obsessive-compulsive disorder). The fourth cluster had 29.5% of the patients and was characterized by the absence of any DSM-IV comorbid disorder.Conclusions: The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of demoralization as encompassed by the DCPR. Subtyping demoralization may yield improved targets for psychosomatic research and treatment trials.

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Persistent Psychological Distress in Patients Treated for Endocrine Disease

Cited by 83 publications

References 17 publications

Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome

Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome

Psychosocial Factors Associated with Polycystic Ovary Syndrome: a Case Control Study

Subtyping demoralization in the medically ill by cluster analysis

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