Síndrome de ovario poliquístico: una revisión de sus correlatos patológicos en el ánimo y en el rendimiento cognitivo / Polycystic ovary syndrome: a review of its pathological correlates in mood and cognitive performance

El Síndrome de ovario poliquístico (SOP) constituye la endocrinopatía más frecuente en las mujeres en edad reproductiva. En los últimos años se avanzó considerablemente en la comprensión clínica y fisiopatológica del SOP. Sin embargo los aspectos comportamentales del SOP continúan siendo menos claros. El objetivo del actual trabajo radicó en revisar las alteraciones en el ánimo y en el rendimiento cognitivo en mujeres con SOP. Se buscaron artículos originales publicados en las bases de datos Pubmed y Science direct (lapso 2006-2015). Se concluye que las mujeres con SOP experimentan con frecuencia depresión y trastornos de ansiedad. El índice de masa corporal resultó el principal predictor de psicopatología. Un estudio longitudinal de grandes dimensiones desestimó un mayor riesgo para trastornos bipolares. Por otro lado algunos estudios señalaron dificultades en el rendimiento cognitivo en mujeres con SOP, particularmente en funciones verbales. En cuanto a un supuesto perfil cognitivo más masculino en el SOP, existen evidencias a favor y evidencias en contra. En fin, no es posible confirmar la presencia de déficits cognitivos, ni tampoco un perfil específico en el SOP, ya que la investigación sobre sus aspectos cognitivos continúa siendo muy escasa. Respecto a los mecanismos explicativos de las alteraciones comportamentales del SOP, se propone la existencia tanto de factores biológicos como psicosocioculturales. Por último, y a raíz de la revisión actual, se sugiere asignar mayor relevancia clínica a los trastornos asociados al ánimo en mujeres con SOP e incrementar la investigación sobre los aspectos cognitivos de esta enfermedad...

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disease in women of reproductive age. In recent years substantial progress was made in the clinical and pathophysiological understanding of PCOS. However the behavioral aspects of PCOS are still less clear. The aim of the present work was to review the changes in mood and cognitive performance in women with PCOS. We searched for original articles published in the databases Pubmed and Science direct (period 2006-2015). It is concluded that women with PCOS frequently experience depression and anxiety disorders. The body mass index was the main predictor of psychopathology. Meanwhile, a large longitudinal study dismissed an increased risk for bipolar disorder. On the other hand, some studies reported difficulties in cognitive performance in women with PCOS, particularly in verbal functions. As for a course more masculine cognitive profile in the PCOS, there are evidences in favor and against. It is not possible to confirm the presence of cognitive deficits in PCOS , nor a specific profile, because the research on the cognitive aspects of PCOS remains scarce. Regarding mechanisms explanatory of behavioral disturbances in PCOS, it is proposed the existence of biological and psychosocial/cultural factors. Following the current review, it is suggested allocate clinical relevance for mood disorders in women with PCOS and increase research of its cognitive aspects...

A Body Divided: Toward Reunification of the Paradigm.

Symptoms without obvious physical cause are commonly reported in medical practice; when chronic, they can have a significant influence on patients' well-being. When traditional medicine is unable to provide relief, sufferers of such conditions often turn to alternative therapies. Western medicine has historically viewed the body through a silo model, i.e, a whole consisting of disparate body systems with well-defined boundaries and little relevant interaction. This model ignores the myriad of interactive functions that each system must require and hinders understanding of syndromes for which etiology is not confined to one organ system, particularly those with a strong psychosocial component. In addition, this model is increasingly shown to be antiquated: recent evidence of Pavlovian conditioning of physiological processes (i.e., placebo and nocebo affects, immune system conditioning), physiological distinctions between multiple personalities, and the pervasive effects of psychosocial stress on every body system (down to the level of the genome) demand a new paradigm. As our appreciation expands of the innumerable interactions between body systems as well as those between all body systems and the mind, the human body is revealed to be a complex web of neurological, immunologic and endocrine interactions that in turn modulate a fluid epigenetic base. Firmly planted in the rationalistic viewpoint that is the foundation of Western medicine, but inclusive of the more wholistic (mind and body) view of Eastern medicine, a nexus model which views the body as the series of multi-connected, interacting physiological webs is essential to continued progress in medicine.

Two interesting cases highlighting an oblivious specialty of psychoneuroendocrinology.

Psychoneuroendocrinology deals with the overlap disorders pertaining to three different specialties. Awareness about the somatic manifestations of psychiatric diseases and vice versa is a must for all the clinicians. The knowledge of this interlinked specialty is essential because of the obscure presentation of certain disorders. Our first case was treated as depressive disorder, whereas the diagnosis was hypogonadism with empty sella. Our second patient was managed as schizophrenia and the evaluation revealed bilateral basal ganglia calcification and a diagnosis of Fahr's disease. We report these cases for their unusual presentation and to highlight the importance of this emerging specialty.