Other potential features mentioned are: menstrual irregularity, subfertility, obesity, hirsutism, acne, and abnormal biochemistry, namely elevations of serum testosterone, androstenedione, luteinizing hormone, and insulin. They point to hyperandrogenism, ovulatory dysfunction, and polycystic ovaries (as seen on ultrasound) as the key diagnostic features. They emphasize the uncertainty of the natural history of this syndrome and its clinical implications.
These guidelines highlight the necessity to avoid over diagnosis, especially in adolescents. International guidelines have been developed with the aim of integrating the best available evidence on diagnosis, assessment, and treatment and improving clinical care ( 2). It is a heterogenous clinical condition, with a range of different phenotypes, a clinical reality that results in divergent opinions regarding diagnosis and treatment. Polycystic ovary syndrome (PCOS) is among the most common endocrine disorders, affecting 5.6–21.3% of women of reproductive age worldwide ( 1, 2). Based on these assumptions, the aims of this paper are to review the association of PCOS and psychotic disorders in order to address the burden of women comorbid for both conditions. Clinical and preclinical data indicate neuroendocrine involvement with dysfunction in gamma-Aminobutyric acid (GABA) signaling and neuronal androgen receptors that might reduce hypothalamic sensitivity and lead to an impairment of estradiol and progesterone feedback. The underlying pathophysiology of PCOS is not fully understood, but it can lead to a number of co-morbidities, including hypertension, diabetes, dyslipidemia, and also, mental health disorders. This discrepancy is related to the population studied and the diagnostic criteria used. The prevalence can vary between 5.6 to 21.3% in women and 6% in adolescent girls. Polycystic ovary syndrome (PCOS), a disease that usually emerges during adolescence, is characterized by hormonal imbalance and ovarian dysfunction. 2Santa Casa Medical School of Sao Paulo, Sao Paulo, Brazil.1First Episode Psychosis Program, Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil.Larissa Doretto 1, Flora Chaves Mari 2 and Ana Cristina Chaves 1*