Differences between infertile women with and without PCOS in terms of anxiety, coping styles, personality traits, and social adjustment: a case-control study.
- 作者列表："Basirat Z","Faramarzi M","Chehrazi M","Amiri M","Ghofrani F","Tajalli Z
PURPOSE:The aim of the study was to identify differences in the level of anxiety, stress coping ways, personality traits, and social adjustments in infertile women with polycystic ovary syndrome (PCOS) compared to those without PCOS. METHODS:In a case-control study, 257 infertile of women were recruited at Fatemeh Azahra Infertility and Reproductive Health Research Center (Babol, Iran) from May 2016 to December 2017. A total of 135 women with PCOS and 122 women without PCOS completed the following questionnaires; State-Trait Anxiety Inventory (STAI), Ways of Coping Questionnaire (WCQ), NEO Five-Factor Inventory (NEO-FFI), and Bell's Adjustment Inventory. RESULTS:Infertile women with PCOS had a higher mean score of trait anxiety than those without PCOS (46.19 ± 5.29 vs 44.49 ± 5.13, P = 0.004), but no difference was observed for state anxiety. The two groups did not have any significant differences in the mean scores of social adjustment and ways of coping, except for social support and problem-focused coping which were higher in the PCOS group. The PCOS personality traits of PCOS infertile women were not different regarding neuroticism, extraversion, agreeableness, conscientiousness. The only exception was that infertile PCOS women had a significantly higher mean score of openness to experience than those without PCOS (P = 0.049). CONCLUSIONS:Clinicians could take advantage of the psychological differences of infertile women with PCOS and without PCOS for better management of PCOS in infertility settings; despite higher levels of anxiety they are more likely to cope with stress and are welcome to new experiences.
目的: 本研究的目的是确定患有多囊卵巢综合征 (PCOS) 的不孕女性与没有PCOS的不孕女性在焦虑水平，压力应对方式，人格特征和社会适应方面的差异。 方法: 在一项病例对照研究中，从2016年5月至2017年12月在Fatemeh Azahra不孕不育和生殖健康研究中心 (伊朗Babol) 招募了257名不孕妇女。135例PCOS女性和122例非PCOS女性完成了以下问卷调查: 状态-特质焦虑量表 (STAI) 、应对方式问卷 (WCQ) 、新五因素量表 (NEO-FFI) 和贝尔调整量表。 结果: PCOS不孕女性的特质焦虑平均得分高于非PCOS女性 (46.19 ± 5.29 vs 44.49 ± 5.13，p = 0.004)，但状态焦虑无差异。除社会支持和以问题为中心的应对方式高于PCOS组外，两组在社会适应和应对方式的平均得分上无显著差异。PCOS不孕妇女的PCOS人格特征在神经质、外向性、宜人性、尽责性方面无差异。唯一的例外是不孕的PCOS妇女比无PCOS的妇女具有显著更高的开放经验的平均得分 (p = 0.049)。 结论: 临床医生可以利用PCOS不孕妇女和无PCOS不孕妇女的心理差异，更好地管理不孕环境中的PCOS; 尽管焦虑程度较高，但他们更有可能应对压力，欢迎新的经验。
METHODS:INTRODUCTION:Cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) is an effective treatment option for selected patients with peritoneal metastases (PM), but national utilization patterns are poorly understood. The objectives of this study were to (1) describe population-based trends in national utilization of CRS/IPC; (2) define the most common indications for the procedure; and (3) characterize the types of hospitals performing the procedure. METHODS:The National Inpatient Sample (NIS) was used to identify patients from 2006 to 2015 who underwent CRS/IPC, and to calculate national estimates of procedural frequency and oncologic indication. Hospitals performing CRS/IPC were classified based on size and teaching status. RESULTS:The estimated annual number of CRS/IPC cases increased significantly from 189 to 1540 (p < 0.001). Overall, appendiceal cancer was the most common indication (25.7%), followed by ovarian cancer (23.3%), colorectal cancer (22.5%), and unspecified PM (15.0%). Remaining cases (13.5%) were performed for other indications. Most cases were performed in large teaching hospitals (65.9%), compared with smaller teaching hospitals (25.1%), large non-teaching hospitals (5.3%), or small non-teaching hospitals (3.2%). Patients were more likely to undergo CRS/IPC without a diagnosis based on level I evidence (appendiceal, ovarian, or colorectal) at large non-academic hospitals (odds ratio 2.00, 95% confidence interval 1.18-3.38, p = 0.010) compared with large academic hospitals. CONCLUSIONS:Utilization of CRS/IPC is increasing steadily in the US, is performed at many types of facilities, and often for a variety of indications that are not supported by high-level evidence. Given associated morbidity of CRS/IPC, a national registry dedicated to cases of IPC is necessary to further evaluate use and outcomes.
METHODS::Results of epidemiologic studies of physical activity and ovarian cancer risk are inconsistent. Few have attempted to measure physical activity over the lifetime or in specific age windows, which may better capture etiologically relevant exposures. We examined participation in moderate-to-vigorous recreational physical activity (MVPA) in relation to ovarian cancer risk. In a population-based case-control study conducted in Montreal, Canada from 2011 to 2016 (485 cases and 887 controls), information was collected on lifetime participation in various recreational physical activities, which was used to estimate MVPA for each participant. MVPA was represented as average energy expenditure over the lifetime and in specific age-periods in units of metabolic equivalents (METs)-hours per week. Odds ratios (OR) and 95% confidence intervals (CI) for the relation between average MVPA and ovarian cancer risk were estimated using multivariable logistic regression models. Confounding was assessed using directed acyclic graphs combined with a change-in-estimate approach. The adjusted OR (95% CI) for each 28.5 MET-hr/week increment of lifetime recreational MVPA was 1.11 (0.99-1.24) for ovarian cancer overall. ORs for individual age-periods were weaker. When examined by menopausal status, the OR (95% CI) for lifetime MVPA was 1.21 (1.00-1.45) for those diagnosed before menopause and 1.04 (0.89-1.21) for those diagnosed postmenopausally. The suggestive positive associations were stronger for invasive ovarian cancers and more specifically for high-grade serous carcinomas. These results do not support a reduced ovarian cancer risk associated with MVPA.
METHODS::The aim of our study was to evaluate whether cardiovascular disease risks seen in adults with polycystic ovary syndrome (PCOS) develop in adolescents with PCOS using conventional Doppler echocardiography (CDE) and tissue Doppler echocardiography (TDE) or not. The other aim was to investigate the association of paraoxonase-1 (PON-1) level with cardiovascular parameters. 30 PCOS patients and 30 control patients were included in the study. All patients were evaluated with TDE and CDE. Paraoxonase-1 levels of both groups were studied. In CDE study, myocardial performance index (MPI) was higher in the PCOS group than in the control group (0.54 ± 0.11, 0.50 ± 0.12, p = .049, respectively). In the TDE study, early diastolic myocardial velocity (E)'/late diastolic myocardial velocity (A') was lower in PCOS group than in the control group (2.07 ± 0.08, 2.44 ± 0.10, p = .008, respectively). PON-1 was higher in PCOS group than in the control group (26.81 ± 3.05, 18.68 ± 1.18, p = .011, respectively). Cardiovascular disease risks, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. The high PON-1 level was thought to increase in response to increased oxidative stress in PCOS.Impact statementWhat is already known on this subject? Polycystic ovary syndrome (PCOS) is one of the most commonly seen endocrinopathy in the adolescent age group. PCOS has detrimental effects on the cardiovascular system in the adult population which is reported in many studies.What the results of this study add? The result of this study showed that cardiovascular effects, which are among the long-term complications of PCOS, seem to begin from the early stage of PCOS. And also, serum paraoxonase-1 level increases in response to the oxidative stress in the adolescent with PCOS.What are the implications of these findings for clinical practice and/or further research? The cardiovascular system evaluation should be started in early phases of PCOS development in the adolescent age group. The potential role of oxidative effect of Paraoxonase-1 on the PCOS needs to be elucidated in further studies.