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16. Changes in Mood, Anxiety, and Cognition with Polycystic Ovary Syndrome Treatment: A Longitudinal, Naturalistic Study

Author

Sukhapure M, Eggleston K, Fenton A, Frampton C, Porter RJ, and Douglas KM

Subjects
androgen, depression, cognitive function, testosterone, spironolactone, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

Mayouri Sukhapure,1,2 Kate Eggleston,1,3 Anna Fenton,4,5 Christopher Frampton,1 Richard J Porter,1,3 Katie M Douglas1 1Department of Psychological Medicine, University of Otago, Christchurch, Canterbury, New Zealand; 2Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia; 3Specialist Mental Health Services, Canterbury District Health Board, Christchurch, Canterbury, New Zealand; 4Department of Endocrinology, Canterbury District Health Board, Christchurch, Canterbury, New Zealand; 5Oxford Women’s Health, Christchurch, Canterbury, New ZealandCorrespondence: Katie M Douglas, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, 8140, New Zealand, Tel +64 3 3726700, Fax +64 3 3720407, Email katie.douglas@otago.ac.nzPurpose: Individuals with polycystic ovary syndrome (PCOS) are at increased risk of depression and anxiety symptoms and impairment in aspects of cognitive function. However, there is little evidence regarding effects of standard treatment for PCOS on these features of the syndrome. The aim of this study was to examine the effect of 12 weeks of naturalistic treatment of PCOS, with usual medications, on depression symptoms, anxiety symptoms and cognitive function.Patients and Methods: Thirty-three participants with PCOS received 12 weeks of individualised treatment based on clinical presentation. Changes in depression and anxiety symptoms were assessed with the self-report Hospital Anxiety and Depression Scale at baseline and 12 weeks, and cognitive function was assessed at the same time-points with a battery of tests spanning cognitive domains of verbal learning and memory, visuospatial learning and memory, psychomotor speed, attention and executive function. Outcomes were compared with a control group of 40 healthy participants.Results: Participants with PCOS (mean age = 29.2 years; mean Body Mass Index = 27.4) were treated with a variety of medications, predominantly spironolactone (n = 22) and oral contraceptives (n = 16). Depression and anxiety symptoms improved significantly over the course of treatment, with moderate effect sizes (Cohen’s d 0.43– 0.55, p < 0.05). Effect sizes of the difference in change from that of the control group were moderate but did not reach statistical significance. Women undergoing PCOS treatment demonstrated significant improvements in aspects of cognitive function, but improvement did not differ significantly from controls and effect size changes were similar, suggesting practise effects in both groups.Conclusion: Our study provides preliminary evidence that treatment of PCOS may be associated with improvement in psychiatric aspects of the syndrome, particularly depressive symptoms.Keywords: androgen, depression, cognitive function, testosterone, spironolactone

Published
2022

17. Epigenetic Measures of ‘Biological Ageing’ Associated With Cardiovascular Risk in Non-Pacific Populations do not Predict Cardiovascular Risk in a Cohort of Samoans, Tongans, and Fijians Living in Aotearoa New Zealand

Author

Gibbs, S., primary, Jones, G., additional, Cameron, V., additional, Fakahau, P., additional, Frampton, C., additional, Earle, N., additional, Poppe, K., additional, Troughton, R., additional, Pilbrow, A., additional, and Fa'atoese, A., additional

Published
2024
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32. Assessing the Mortality Rate After Primary Total Knee Arthroplasty: An Observational Study to Inform Future Economic Analysis

Author

Zhou, Y, Frampton, C, Dowsey, M, Choong, P, Schilling, C, Hirner, M, Zhou, Y, Frampton, C, Dowsey, M, Choong, P, Schilling, C, and Hirner, M

Abstract

BACKGROUND: Previous research has focused on the perioperative or short-term (<1 year) mortality rate of total knee arthroplasty (TKA), leaving the long-term (>1 year) mortality rate unresolved. In this study, we calculated the mortality rate up to 15 years after primary TKA. METHODS: Data from the New Zealand Joint Registry from April 1998 to December 2021 were analyzed. Patients aged 45 years or older who underwent TKA for osteoarthritis were included. Mortality data were linked with national records from births, deaths, and marriages. To determine the expected mortality rates in the general population, age-sex-specific life tables from statistics New Zealand were used. Mortality rate was presented as standardized mortality ratios (SMRs) - a comparison of relative mortality rate between the TKA and general populations. In total, 98,156 patients with a median follow-up of 7.25 years (range, 0.00 to 23.74) were included. RESULTS: Over the entire follow-up period, 22,938 patients (23.4%) had died. The overall SMR for the TKA cohort was 1.08 (95% confidence interval (CI): 1.06 to 1.09), suggesting that TKA patients have an 8% higher mortality rate compared to the general population. However, a reduction in short-term mortality rate was observed for TKA patients up to 5 years post TKA (SMR 5 years post TKA; 0.59 95% CI: 0.57 to 0.60]). On the contrary, a significantly increased long-term mortality rate was observed in TKA patients with greater than 11 years of follow-up, particularly in men over the age of 75 years (SMR 11 to 15 years post TKA for males ≥ 75 years; 3.13 [95% CI: 2.95 to 3.31]). CONCLUSION: The results suggest a reduction in short-term mortality rate for patients who undergo primary TKA. However, there is an increased long-term mortality rate particularly in men over the age of 75 years. Importantly, the mortality rates observed in this study cannot be causally attributed to TKA alone.

Published
2023

40. Economic living standard and abdominal pain mediate the association between functional gastrointestinal disorders and depression or anxiety

Author

Simon M. H., Heenan P. E., Frampton C., Bayer S., Keenan J. I., Boer de N. K., Roy N. C., Talley N. J., and Gearry R. B.

Subjects
Male, Diarrhea, Endocrine and Autonomic Systems, Physiology, Depression, Gastrointestinal Diseases, Gastroenterology, Anxiety, Abdominal Pain, Irritable Bowel Syndrome, Socioeconomic Factors, Case-Control Studies, Surveys and Questionnaires, Humans, Female, Constipation
Abstract

Functional gastrointestinal disorders (FGIDs) are common and cause significant morbidity. Psychiatric comorbidities associated with FGIDs include anxiety and depression. However, little is understood about the factors that modulate this association. The aim of this study was to examine the association between FGIDs and depression and anxiety, and to determine the covariates influencing this association in a New Zealand cohort.The Christchurch IBS cOhort to investigate Mechanisms FOr gut Relief and improved Transit (COMFORT) study is an observational case-control study that recruited FGID cases and healthy controls between 2016 and 2018. In addition to the collection of a wide range of biological samples, participants completed questionnaires concerning socioeconomic status, physical activity, smoking, alcohol intake, anxiety, and depression (the latter two measured using the Hospital Anxiety and Depression Score [HADS]). A multivariate analysis was performed using the significant covariates from the univariate analyses to test whether their effect was independently significant on anxiety and depression.A total of 315 participants (57 with diarrhea-predominant IBS (IBS-D), 30 with constipation-predominant IBS (IBS-C), 41 with mixed-IBS (IBS-M), 16 with functional diarrhea (FD), 42 with functional constipation (FC), and 129 controls); mean age 53 years (range 18-70 years), 221 (70%) female) completed the questionnaires. Anxiety (odds ratio [OR] 2.85 [95% confidence interval [CI] 1.64-4.94, p 0.01) and depression (OR 3.40 [95% CI 1.35-8.55, p = 0.01]) were strongly associated with FGID cases versus controls. Lower economic living status (p 0.01) was an independent covariate associated with depression, while lower economic living status (p 0.005) and abdominal pain (p = 0.005) were both independently associated with anxiety.In addition to the established associations between FGIDs and anxiety and depression, we have shown that the economic standard of living, pain, and IBS phenotype are significant independent covariates. This study demonstrates the range of lifestyle and demographic factors that modulate morbidity associated with FGIDs and may provide targets for intervention.

Published
2022

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