Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis

Background: The association between depression, anxiety, and polycystic ovary syndrome (PCOS) is still unclear. Therefore, a systematic review and meta-analysis was conducted to assess the rates of comorbid psychiatric disorders among women with PCOS compared to women without it. Methods: PubMed/MEDLINE, Embase, PsycINFO, and Web of Science databases were searched from inception to November 27, 2015. Studies were eligible for inclusion if they were original reports in which the rates of mood (bipolar disorder, dysthymia, or major depressive disorder), obsessive-compulsive spectrum disorders, trauma- and stressor-related disorders, anxiety disorders or psychotic disorders, somatic symptom and related disorders, or eating disorders had been investigated among women with an established diagnosis of PCOS and compared with women without PCOS. Psychiatric diagnosis should have been established by means of a structured diagnostic interview or through a validated screening tool. Data were extracted and pooled using random effects models. Results: Six studies were included in the meta-analysisof these, five reported the rates of anxiety and six provided data on the rates of depression. The rate of subjects with anxiety symptoms was higher in patients with PCOS compared to women without PCOS (odds ratio (OR) =2.7695% confidence interval (CI) 1.26 to 6.02Log OR = 1.013P=0.011). The rate of subjects with depressive symptoms was higher in patients with PCOS compared to women without PCOS (OR = 3.5195% CI 1.97 to 6.24Log OR =1.255P < 0.001). Conclusion: Anxiety and depression symptoms are more prevalent in patients with PCOS.National Council for Scientific and Technological Development (CNPqConselho Nacional de Desenvolvimento Cientifico e Tecnologico) [305274/2014-7]Department of Psychiatry, Federal University of São Paulo (Escola Paulista de Medicina – UNIFESP), São Paulo, SP, BrazilDepartment of Psychiatry, Fortaleza University, Fortaleza, Ceará, BrazilLaboratory of Molecular Psychiatry Federal University of Rio Grande do Sul, Rio Grande do Sul, BrazilDepartment of Psychiatry, Federal University of Rio Grande do Sul, Rio Grande do Sul, BrazilDepartment of Psychiatry, Federal University of São Paulo (Escola Paulista de Medicina – UNIFESP), R Borges Lagoa 570, BR-04038020 Sao Paulo, SP, Brazil.CNPq: 305274/2014-7Web of Scienc

Clinical signature among victims of intimate partner violence : a study using text classification tools

Introduction: Intimate partner violence is a major public health problem and a violation of women's human rights. It is important to explore the speech of the victim at the time of the complaint. Objective: To analyze the text classification with word cloudas a tool to understand the pattern of patient functioning, complementing the qualitative analysis. Method: It is a text classification study with a word cloud analysis technique, complementing the qualitative analysis. The sample is fifty-six women victims of self-reported domestic violence, who came from a public service in South of Brazil. Results: A word cloud was developed from the speech of the 56 participants. Discussion: The women's discourse in the interviews had focused on understanding what had really happened in their relationship, reporting their abusive situations. Studies using this technique benefit from including heterogeneous patients considering their idiosyncrasies to develop a complex nonlinear pattern relating predictors to the clinical outcome. Conclusion: It was possible to understand the pattern of patient functioning from the text classification tool. The violence or a consequence of it represents internal obstacles of the victim to regulate her emotional experience and stress

Precision non-implantable neuromodulation therapies : a perspective for the depressed brain

Current first-line treatments for major depressive disorder (MDD) include pharmacotherapy and cognitive-behavioral therapy. However, one-third of depressed patients do not achieve remission after multiple medication trials, and psychotherapy can be costly and time-consuming. Although nonimplantable neuromodulation (NIN) techniques such as transcranial magnetic stimulation, transcranial direct current stimulation, electroconvulsive therapy, and magnetic seizure therapy are gaining momentum for treating MDD, the efficacy of non-convulsive techniques is still modest, whereas use of convulsive modalities is limited by their cognitive side effects. In this context, we propose that NIN techniques could benefit from a precision-oriented approach. In this review, we discuss the challenges and opportunities in implementing such a framework, focusing on enhancing NIN effects via a combination of individualized cognitive interventions, using closed-loop approaches, identifying multimodal biomarkers, using computer electric field modeling to guide targeting and quantify dosage, and using machine learning algorithms to integrate data collected at multiple biological levels and identify clinical responders. Though promising, this framework is currently limited, as previous studies have employed small samples and did not sufficiently explore pathophysiological mechanisms associated with NIN response and side effects. Moreover, cost-effectiveness analyses have not been performed. Nevertheless, further advancements in clinical trials of NIN could shift the field toward a more ‘‘precision-oriented’’ practice

Precision psychiatry : the future is now

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Virginia Woolf, neuroprogression, and bipolar disorder

Family history and traumatic experiences are factors linked to bipolar disorder. It is known that the lifetime risk of bipolar disorder in relatives of a bipolar proband are 5-10% for first degree relatives and 40-70% for monozygotic co-twins. It is also known that patients with early childhood trauma present earlier onset of bipolar disorder, increased number of manic episodes, and more suicide attempts. We have recently reported that childhood trauma partly mediates the effect of family history on bipolar disorder diagnosis. In light of these findings from the scientific literature, we reviewed the work of British writer Virginia Woolf, who allegedly suffered from bipolar disorder. Her disorder was strongly related to her family background. Moreover, Virginia Woolf was sexually molested by her half siblings for nine years. Her bipolar disorder symptoms presented a pernicious course, associated with hospitalizations, suicidal behavioral, and functional impairment. The concept of neuroprogression has been used to explain the clinical deterioration that takes places in a subgroup of bipolar disorder patients. The examination of Virgina Woolf’s biography and art can provide clinicians with important insights about the course of bipolar disorder