Cognitive-behavioral therapy improves weight loss and quality of life in women with polycystic ovary syndrome: a pilot randomized clinical trial - Fertility and Sterility

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. A 16-week pilot randomized clinical trial. Tertiary-care PCOS center. Overweight/obese women with PCOS and depressive symptoms. Weekly CBT (n = 7) or contact only/no therapy (n = 8) for 8 weeks. Both groups received weekly LS for 16 weeks. 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). 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. 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. NCT01899001. La terapia cognitivo-conductual mejora la pérdida de peso y la calidad de vida en mujeres con síndrome de ovario poliquístico: un ensayo clínico piloto aleatorizado Comparar los efectos de la terapia cognitivo-conductual (CBT) y las modificaciones del estilo de vida (LS) frente a la modificación únicamente del estilo de vida (LS) en el peso, síntomas de ansiedad y depresión, y respuesta al estrés en mujeres con síndrome de ovario poliquístico (PCOS), sobrepeso/obesidad, y síntomas de depresión. Ensayo clínico piloto aleatorizado de 16 semanas. Centro de cuidado terciario para pacientes con PCOS. Mujeres obesas/con sobrepeso con PCOS y síntomas depresivos. CBT semanal (n:7) o solo control/sin terapia (n:8) durante 8 semanas. Ambos grupos recibieron modificación de su estilo de vida semanal durante 16 semanas. Cambios en el peso, grado de depresión (Escala de depresión del centro de estudios