title: Insulin resistance, obesity, inflammation, and depression in polycystic ovary syndrome: biobehavioral mechanisms and interventions.
abstract: OBJECTIVE
  To summarize physiological and psychological characteristics that are common among women diagnosed with polycystic ovary syndrome (PCOS) and provide evidence suggesting that addressing psychological disturbances can reduce or alleviate physical symptoms of PCOS through behavioral pathways and physiological pathways.
  
  
  METHODS
  Empirical studies and expert consensuses pertaining to physiological, psychological, and medical management aspects of PCOS were identified and presented in this review. Articles were identified by searching Pubmed, PsycInfo, Medline ISI, CINAHL, or a Web browser (i.e., Google) using numerous combinations of terms pertaining to physiological, psychological, and medical management aspects of PCOS. An article was chosen to be included in this review if it reported findings and/or provided information that related to and helped support the main purpose(s) of this review article.
  
  
  RESULTS
  Available literature on the physiological (i.e., hyperandrogenism, central obesity, inflammation, insulin resistance) and psychological (i.e., depression, anxiety, eating disorders) factors among women with PCOS provides evidence that these various aspects of PCOS are strongly interrelated.
  
  
  CONCLUSIONS
  The existence of these relationships among physiological and psychological factors strongly suggests that medical management of PCOS would greatly benefit from inclusion of psychological and behavioral approaches.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA. k.farrell1@umiami.edu
authors.forename: Kristen
authors.initials: K
authors.lastname: Farrell
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
mesh_terms: D001521:Behavior Therapy; D003863:Depression / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology / Q000523:psychology; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D056128:Obesity, Abdominal / Q000503:physiopathology / Q000523:psychology; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy
references.citation: Clin Endocrinol (Oxf). 2008 Nov;69(5):792-8
references.pmid: 18505468
references.citation: Fertil Steril. 1990 Aug;54(2):245-50
references.pmid: 2165925
references.citation: Metabolism. 1995 Apr;44(4):525-31
references.pmid: 7723677
references.citation: N Engl J Med. 2002 Feb 7;346(6):393-403
references.pmid: 11832527
references.citation: Lancet. 2007 Aug 25;370(9588):685-97
references.pmid: 17720020
references.citation: Hum Reprod Update. 2007 Nov-Dec;13(6):527-37
references.pmid: 17767003
references.citation: Br J Dermatol. 1999 Apr;140(4):672-6
references.pmid: 10233319
references.citation: Neurosci Biobehav Rev. 2005;29(4-5):891-909
references.pmid: 15885777
references.citation: J Consult Clin Psychol. 2000 Feb;68(1):31-45
references.pmid: 10710838
references.citation: Proc Natl Acad Sci U S A. 2000 Jan 4;97(1):325-30
references.pmid: 10618417
references.citation: Ann Intern Med. 1997 Jan 1;126(1):32-5
references.pmid: 8992921
references.citation: Psychosom Med. 2004 May-Jun;66(3):356-62
references.pmid: 15184695
references.citation: Circulation. 2002 Jul 2;106(1):81-5
references.pmid: 12093774
references.citation: Fertil Steril. 2009 Jul;92(1):240-9
references.pmid: 18692809
references.citation: Reprod Biomed Online. 2006 May;12(5):569-78
references.pmid: 16790100
references.citation: Hum Reprod. 2006 Apr;21(4):1092-9
references.pmid: 16459352
references.citation: Lancet. 1988 Apr 16;1(8590):870-2
references.pmid: 2895373
references.citation: Arch Physiol Biochem. 2008 Oct;114(4):211-23
references.pmid: 18946782
references.citation: Int J Cardiol. 2005 Apr 8;100(1):93-9
references.pmid: 15820291
references.citation: Clin Endocrinol (Oxf). 2004 Jan;60(1):1-17
references.pmid: 14678281
references.citation: Mol Psychiatry. 1999 Mar;4(2):182-8
references.pmid: 10208451
references.citation: Postgrad Med J. 1993 Mar;69(809):186-9
references.pmid: 8497431
references.citation: Fertil Steril. 2009 Jan;91(1):207-12
references.pmid: 18249398
references.citation: Psychosom Med. 2000 Sep-Oct;62(5):633-8
references.pmid: 11020092
references.citation: Psychoneuroendocrinology. 2009 Jun;34(5):727-35
references.pmid: 19150179
references.citation: J Health Psychol. 2003 May;8(3):327-45
references.pmid: 14670212
references.citation: Eur J Endocrinol. 2009 Oct;161(4):583-9
references.pmid: 19605540
references.citation: Appetite. 2007 Nov;49(3):590-3
references.pmid: 17509728
references.citation: Hum Reprod. 2008 Jan;23(1):153-9
references.pmid: 18024952
references.citation: J Clin Endocrinol Metab. 2006 Jan;91(1):336-40
references.pmid: 16249279
references.citation: Int J Obes (Lond). 2006 Oct;30(10):1557-64
references.pmid: 16534529
references.citation: Fertil Steril. 2009 Jul;92(1):250-5
references.pmid: 18678372
references.citation: Psychiatry Res. 1993 Oct;49(1):11-27
references.pmid: 7511248
references.citation: Fertil Steril. 2000 Apr;73(4):812-6
references.pmid: 10731545
references.citation: Lancet. 1990 Feb 24;335(8687):431-3
references.pmid: 1968168
references.citation: J Clin Endocrinol Metab. 2000 Jan;85(1):139-46
references.pmid: 10634377
references.citation: Psychosom Med. 2000 May-Jun;62(3):304-8
references.pmid: 10845343
references.citation: Trends Endocrinol Metab. 2002 Aug;13(6):251-7
references.pmid: 12128286
references.citation: J Clin Endocrinol Metab. 1991 Jan;72(1):83-9
references.pmid: 1898744
references.citation: Biol Psychiatry. 2001 Mar 1;49(5):391-404
references.pmid: 11274650
references.citation: Am J Psychiatry. 2003 Sep;160(9):1554-65
references.pmid: 12944327
references.citation: Diabet Med. 2008 Oct;25(10):1133-41
references.pmid: 19046190
references.citation: Arterioscler Thromb Vasc Biol. 2002 Nov 1;22(11):1869-76
references.pmid: 12426218
references.citation: J Pediatr Endocrinol Metab. 2000 Mar;13(3):253-9
references.pmid: 10714750
references.citation: Eur J Clin Nutr. 2008 Sep;62(9):1047-57
references.pmid: 17554247
references.citation: J Neurol Neurosurg Psychiatry. 2005 Apr;76(4):469-75
references.pmid: 15774430
references.citation: Brain Behav Immun. 2003 Oct;17(5):350-64
references.pmid: 12946657
references.citation: Endocr Pract. 2009 Jul-Aug;15(5):475-82
references.pmid: 19454378
references.citation: J Am Acad Child Adolesc Psychiatry. 2008 Feb;47(2):148-155
references.pmid: 18176336
references.citation: BMJ. 2005 Jan 1;330(7481):17-8
references.pmid: 15604155
references.citation: J Endocrinol. 2006 Mar;188(3):521-9
references.pmid: 16522732
references.citation: Endocrinology. 2008 Jul;149(7):3559-68
references.pmid: 18388196
references.citation: Ann Behav Med. 2000 Winter;22(1):29-37
references.pmid: 10892526
references.citation: Biol Psychiatry. 2003 Aug 1;54(3):330-7
references.pmid: 12893108
references.citation: J Clin Endocrinol Metab. 2003 Feb;88(2):812-9
references.pmid: 12574218
references.citation: Immunol Allergy Clin North Am. 2009 May;29(2):309-20
references.pmid: 19389584
references.citation: J Clin Endocrinol Metab. 2003 Jun;88(6):2562-8
references.pmid: 12788855
references.citation: Am J Clin Nutr. 2000 Jun;71(6):1536-44
references.pmid: 10837296
references.citation: Mol Psychiatry. 2006 Jul;11(7):680-4
references.pmid: 16491133
references.citation: N Engl J Med. 1994 Feb 17;330(7):460-5
references.pmid: 8289851
references.citation: J Clin Endocrinol Metab. 2001 Feb;86(2):517-20
references.pmid: 11158002
references.citation: Gynecol Endocrinol. 2008 Oct;24(10):555-61
references.pmid: 19012098
references.citation: Behav Neurosci. 2001 Feb;115(1):238-42
references.pmid: 11256447
references.citation: J Clin Endocrinol Metab. 1999 Apr;84(4):1470-4
references.pmid: 10199797
references.citation: Arch Gen Psychiatry. 1998 Sep;55(9):816-20
references.pmid: 9736008
references.citation: Diabetes Care. 1999 Jan;22(1):141-6
references.pmid: 10333916
references.citation: Adv Exp Med Biol. 1999;461:283-316
references.pmid: 10442179
references.citation: Fertil Steril. 1995 Jun;63(6):1195-9
references.pmid: 7750588
references.citation: Fertil Steril. 2005 Jun;83(6):1717-23
references.pmid: 15950641
references.citation: Psychosom Med. 2000 Sep-Oct;62(5):623-32
references.pmid: 11020091
references.citation: Trends Immunol. 2006 Jan;27(1):24-31
references.pmid: 16316783
references.citation: J Clin Endocrinol Metab. 2003 Dec;88(12):5801-7
references.pmid: 14671172
references.citation: Trends Pharmacol Sci. 1992 Jan;13(1):24-8
references.pmid: 1542935
references.citation: Clin Sci (Lond). 1999 May;96(5):513-23
references.pmid: 10209084
references.citation: Gynecol Endocrinol. 2006 Jun;22(6):324-8
references.pmid: 16785157
references.citation: Obstet Gynecol. 1986 Oct;68(4):531-6
references.pmid: 3748504
references.citation: Hum Reprod. 2008 Mar;23(3):462-77
references.pmid: 18308833
references.citation: J Pediatr Psychol. 2009 Mar;34(2):156-63
references.pmid: 18556675
references.citation: J Clin Endocrinol Metab. 1998 Jun;83(6):2001-5
references.pmid: 9626131
references.citation: Int J Androl. 2006 Feb;29(1):278-85; discussion 286-90
references.pmid: 16390494
references.citation: J Clin Endocrinol Metab. 2006 Mar;91(3):781-5
references.pmid: 16418211
references.citation: Clin Endocrinol (Oxf). 1990 Feb;32(2):213-20
references.pmid: 2112067
references.citation: Brain Behav Immun. 2001 Mar;15(1):7-24
references.pmid: 11259077
references.citation: Ann Hum Biol. 2008 Nov-Dec;35(6):584-95
references.pmid: 18720090
references.citation: Mult Scler. 1998 Feb;4(1):12-5
references.pmid: 9532586
references.citation: Hum Reprod. 2006 Jul;21(7):1925-34
references.pmid: 16549423
references.citation: Fertil Steril. 2003 Aug;80(2):255-8
references.pmid: 12909480
references.citation: J Clin Endocrinol Metab. 2004 Feb;89(2):806-11
references.pmid: 14764799
references.citation: Proc Natl Acad Sci U S A. 1998 Dec 8;95(25):14956-60
references.pmid: 9843997
references.citation: Hum Reprod. 2008 Sep;23(9):2064-71
references.pmid: 18583330
references.citation: J Allergy Clin Immunol. 2008 May;121(5):1096-102
references.pmid: 18466782
references.citation: J Clin Endocrinol Metab. 1998 Mar;83(3):847-50
references.pmid: 9506738
references.citation: Int J Neuropsychopharmacol. 2002 Dec;5(4):401-12
references.pmid: 12466038
references.citation: Breast Cancer Res Treat. 2007 Aug;104(2):145-52
references.pmid: 17058023
references.citation: J Cardiovasc Med (Hagerstown). 2008 Oct;9(10):987-92
references.pmid: 18799960
references.citation: Acta Physiol Scand. 2001 Mar;171(3):249-57
references.pmid: 11412137
references.citation: Pol J Pharmacol. 1996 Sep-Oct;48(5):503-6
references.pmid: 9112692
references.citation: Med Sci Sports Exerc. 2009 Mar;41(3):497-504
references.pmid: 19204602
references.citation: J Int Med Res. 2008 Nov-Dec;36(6):1188-96
references.pmid: 19094426
references.citation: Hum Reprod. 2008 Mar;23(3):642-50
references.pmid: 18158291
references.citation: Atherosclerosis. 2005 Feb;178(2):339-44
references.pmid: 15694943
references.citation: N Engl J Med. 2000 Sep 28;343(13):938-52
references.pmid: 11006371
references.citation: BMJ. 2001 Mar 24;322(7288):716-20
references.pmid: 11264213
references.citation: Hum Reprod. 2009 Jun;24(6):1446-51
references.pmid: 19223290
references.citation: Arterioscler Thromb Vasc Biol. 2000 Nov;20(11):2414-21
references.pmid: 11073846
references.citation: Sports Med. 2002;32(12):741-60
references.pmid: 12238939
references.citation: N Engl J Med. 2008 Jan 3;358(1):47-54
references.pmid: 18172174
references.citation: J Affect Disord. 2008 Jul;109(1-2):75-82
references.pmid: 18063093
references.citation: Best Pract Res Clin Endocrinol Metab. 2006 Jun;20(2):245-60
references.pmid: 16772155
references.citation: N Engl J Med. 2000 Mar 23;342(12):836-43
references.pmid: 10733371
references.citation: Gynecol Endocrinol. 2004 Aug;19(2):79-87
references.pmid: 15624269
references.citation: J Pediatr Adolesc Gynecol. 2003 Feb;16(1):33-7
references.pmid: 12604144
references.citation: Hum Reprod. 2001 Sep;16(9):1995-8
references.pmid: 11527911
references.citation: Br J Psychiatry. 1997 Oct;171:328-34
references.pmid: 9373420
references.citation: Panminerva Med. 2003 Sep;45(3):189-95
references.pmid: 14618117
references.citation: Trends Mol Med. 2006 Jul;12(7):324-32
references.pmid: 16769248
references.citation: J Neuroimmunol. 1997 Feb;72(2):155-61
references.pmid: 9042108
references.citation: Brain Behav Immun. 2001 Sep;15(3):199-226
references.pmid: 11566046
references.citation: Psychosom Med. 2008 Nov;70(9):1044-9
references.pmid: 18842742
references.citation: Fertil Steril. 2001 Jan;75(1):53-8
references.pmid: 11163816
references.citation: J Neuroimmunol. 2000 Apr 3;104(1):31-6
references.pmid: 10683512
references.citation: Fertil Steril. 2007 Jun;87(6):1369-76
references.pmid: 17397839
references.citation: Psychoneuroendocrinology. 2008 Sep;33(8):1132-8
references.pmid: 18672334