Ανασκόπηση Review

28 H. ΜΟΥΡΙΚΗΣ και Ι. ΖΕΡΒΑΣ ΨΥΧΙΑΤΡΙΚΗ 18 (1), 2007Polycystic ovary syndromeH. Mourikis, J. ZervasDepartment of Psychiatry, University of Athens, "Eginition" Hospital, Athens, GreecePsychiatriki 2007, 18:19–28The Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder in women ofreproductive age with complex but interesting reproductive and metabolic ramifications. Theeffects of various endocrine-hormonal dysfunctions in psychiatry are well known and have beentargeted by scientific study for quite some time. During the past few years, psychiatric research hasshifted its interest to the cellular level. Steroids that originate in the periphery (e.g. ovaries), as wellas those synthesized by the central nervous system (neurosteroids), have neuroplastic effects andinterfere with almost all known neurotransmitter systems. Therefore steroid de-regulation that iscaused by the PCOS is related to psychiatric symptomatology on both a pathophysiological anda clinical level. In medical psychiatric practice, PCOS is related to many disorders: bipolar disorderand its treatment, epilepsy, depression, cognitive disorders, sleep disorders, eating disorders, andsomatoform disorders. On a psychological level, women suffering from PCOS may display depressivesymptoms, anxiety, body image dissatisfaction, diminished sexual interest, and compromisedquality of life. Therefore, we believe that it is useful for the clinical psychiatrist to keep in mind thepsychiatric and the psychological aspects of PCOS, and their impact on patient diagnosis, courseand treatment.Key words: Polycystic ovary syndrome, Psychoendocrinology, Psychiatry, reproductive steroids,review.Bιβλιογραφία1. Lobo RA, Carmina E. The importance of diagnosing the po -lycystic ovary syndrome. Ann Intern Med 2000, 132:989–9932. Knochenhauer ES, Key TJ, Kahsar-Miller M et al. Prevalence ofthe polycystic ovary syndrome in unselected black and whitewomen of the southeastern United States: a prospective study.J Clin Endocrinol Metab 1998, 83:3078–30823. Polson DW, Adams J, Wadsworth J et al. Polycystic ovaries – acommon finding in normal women. Lancet 1988, i:870–8724. The Rotterdam ESHRE/SRM-Sponsored PCOS consensusworkshop group. Revised 2003 consensus on diagnostic criteriaand long-term health risks related to polycystic ovary syndrome(PCOS). Hum Reprod 2004, 19:41–47 (Review)5. Αραβαντινού ∆Ι. Παθολογία της γυναίκας, 1985:144–1456. Hardiman P, Pillay OS, Atiomo W. Polycystic ovary syndromeand endometrial carcinoma. Lancet 2003, 361:1810–18127. Balen A. Polycystic ovary syndrome and cancer. Hum ReprodUpdate 2001, 7:522–5258. Coulam CB, Annegers JF, Kranz JS. Chronic anovulation syn dromeand associated neoplasia. Obstet Gynecol 1983, 61:403–4079. Schildkraut JM, Schwingl PJ, Bastos E et al. Epithelial ovariancancer risk among women with polycystic ovary syndrome.Obstet Gynecol 1996, 88:554–55910. Franks S. Polycystic ovary syndrome. N Engl J Med 1995,333:853–86111. Dunaif A, Thomas A. Current concepts in the polycystic ovarysyndrome. Annu Rev Med 2001, 52:401–41912. Dahlgren E, Janson PO, Johansson S et al. Polycystic ovarysyndrome and risk for myocardial infarction. Evaluated froma risk factor model based on a prospective population studyof women. Acta Obstet Gynecol Scand 1992, 71:599–60413. Ehrmann DA, Barnes RB, Rosenfield RL et al. Prevalenceof impaired glucose tolerance and diabetes in women withpolycystic ovary syndrome. Diabet Care 1999, 22:141–14614. Legro RS, Kunselman AR, Dodson WC et al. Prevalence andpredictors of risk for type 2 diabetes mellitus and impairedglucose tolerance in polycystic ovary syndrome: a prospective,controlled study in 254 affected women. J Clin EndocrinolMetab 1999, 84:165–16915. Legro RS, Kunselman AR, Dunaif A. Prevalence and predictorsof dyslipidemia in women with polycystic ovary syndrome. AmJ Med 2001, 111:607–61316. Gluck CJ, Papannna R, Wang P et al. Incidence and treatmentof metabolic syndrome in newly referred women with confirmedpolycystic ovarian syndrome. Metabolism 2003, 52:908–91517. Legro RS, Strauss JF III, Fox J et al. Evidence for a geneticbasis for hyperandrogenemia in polycystic ovary syndrome.Proc Natl Acad Sci USA 1998, 95:14956–14960