TY - JOUR
T1 - Cognitive-behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome
T2 - a pilot randomized clinical trial
AU - Cooney, Laura G.
AU - Milman, Lauren W.
AU - Hantsoo, Liisa
AU - Kornfield, Sara
AU - Sammel, Mary D.
AU - Allison, Kelly C.
AU - Epperson, C. Neill
AU - Dokras, Anuja
N1 - Funding Information:
The authors thank the University of Pennsylvania Diabetes Research Center (P30-DK19525) and the Translational Core Laboratory at CHOP for running all laboratories and the National Institutes of Health Office of Research on Women's Health for their funding support.
Funding Information:
Supported by a National Institutes of Health (NIH) Reproductive Epidemiology Training Grant (T32-HD007440; L.G.C.), University of Pennsylvania Penn Presbyterian Harrison award (A.D.), and NIH P50 MH099910 and K12 HD085848 (C.N.E.).
Publisher Copyright:
© 2018 American Society for Reproductive Medicine
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Objective: To compare the effects of cognitive-behavioral therapy (CBT) and lifestyle modification (LS) versus LS alone on weight, depressive and anxiety symptoms, and stress response in women with polycystic ovary syndrome (PCOS), overweight/obesity, and depressive symptoms. Design: A 16-week pilot randomized clinical trial. Setting: Tertiary-care PCOS center. Patient(s): Overweight/obese women with PCOS and depressive symptoms. Intervention(s): Weekly CBT (n = 7) or contact only/no therapy (n = 8) for 8 weeks. Both groups received weekly LS for 16 weeks. Main Outcome Measure(s): Changes in weight, depression (Center for Epidemiologic Studies Depression Scale [CES-D]), anxiety (State-Trait Anxiety Inventory [STAI]), quality of life (Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire [PCOSQ]), laboratory tests, and response to a Trier Social Stress Test (TSST). Result(s): The CBT+LS group lost more weekly weight (−0.35 kg/wk vs. −0.16 kg/wk) compared with the LS group. Overall, the CBT+LS group lost 3.2 kg versus 1.8 kg for the LS group. The CBT+LS group had greater improvement in PCOSQ at 8 weeks (+3.7 vs. +1.2 points). In the overall cohort, STAI and CES-D decreased by −0.27 points per week and −0.31 points/wk, respectfully, and total and free T decreased at week 8. Heart rate response to TSST was lower at 15 minutes after stressor in the CBT+LS group. Conclusion(s): Weekly CBT+LS for 8 weeks compared with LS alone resulted in significant weight loss and improved quality of life in overweight/obese women with PCOS and depressive symptoms. These interventions were associated with a decreased autonomic response to a laboratory stressor, suggesting a potential link between CBT, weight loss, and modulation of the stress response. Clinical Trial Registration Number: NCT01899001.
AB - Objective: To compare the effects of cognitive-behavioral therapy (CBT) and lifestyle modification (LS) versus LS alone on weight, depressive and anxiety symptoms, and stress response in women with polycystic ovary syndrome (PCOS), overweight/obesity, and depressive symptoms. Design: A 16-week pilot randomized clinical trial. Setting: Tertiary-care PCOS center. Patient(s): Overweight/obese women with PCOS and depressive symptoms. Intervention(s): Weekly CBT (n = 7) or contact only/no therapy (n = 8) for 8 weeks. Both groups received weekly LS for 16 weeks. Main Outcome Measure(s): Changes in weight, depression (Center for Epidemiologic Studies Depression Scale [CES-D]), anxiety (State-Trait Anxiety Inventory [STAI]), quality of life (Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire [PCOSQ]), laboratory tests, and response to a Trier Social Stress Test (TSST). Result(s): The CBT+LS group lost more weekly weight (−0.35 kg/wk vs. −0.16 kg/wk) compared with the LS group. Overall, the CBT+LS group lost 3.2 kg versus 1.8 kg for the LS group. The CBT+LS group had greater improvement in PCOSQ at 8 weeks (+3.7 vs. +1.2 points). In the overall cohort, STAI and CES-D decreased by −0.27 points per week and −0.31 points/wk, respectfully, and total and free T decreased at week 8. Heart rate response to TSST was lower at 15 minutes after stressor in the CBT+LS group. Conclusion(s): Weekly CBT+LS for 8 weeks compared with LS alone resulted in significant weight loss and improved quality of life in overweight/obese women with PCOS and depressive symptoms. These interventions were associated with a decreased autonomic response to a laboratory stressor, suggesting a potential link between CBT, weight loss, and modulation of the stress response. Clinical Trial Registration Number: NCT01899001.
KW - CBT
KW - PCOS
KW - depression
KW - nutrition
KW - weight loss
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U2 - 10.1016/j.fertnstert.2018.03.028
DO - 10.1016/j.fertnstert.2018.03.028
M3 - Article
C2 - 29908771
AN - SCOPUS:85048723242
SN - 0015-0282
VL - 110
SP - 161-171.e1
JO - Fertility and sterility
JF - Fertility and sterility
IS - 1
ER -