Causality between neuroticism personality clusters and female reproductive diseases in European population: a two-sample bidirectional mendelian randomization study.
Humans
Female
Mendelian Randomization Analysis
Neuroticism
Genome-Wide Association Study
Infertility, Female
/ psychology
Endometriosis
/ psychology
Polycystic Ovary Syndrome
/ psychology
White People
/ psychology
Leiomyoma
/ genetics
Abortion, Spontaneous
/ psychology
Depression
/ genetics
Genital Diseases, Female
/ psychology
Abortion, Habitual
/ genetics
Europe
/ epidemiology
Personality
/ genetics
Causality
Female reproductive diseases
Mendelian randomization
Neuroticism personality clusters
Journal
BMC women's health
ISSN: 1472-6874
Titre abrégé: BMC Womens Health
Pays: England
ID NLM: 101088690
Informations de publication
Date de publication:
12 Sep 2024
12 Sep 2024
Historique:
received:
24
04
2024
accepted:
02
09
2024
medline:
13
9
2024
pubmed:
13
9
2024
entrez:
12
9
2024
Statut:
epublish
Résumé
The causality between neuroticism, a personality trait characterized by the tendency to experience negative emotions, and female reproductive diseases remains unclear. To provide evidence for the development of effective screening and prevention strategies, this study employed Mendelian randomization (MR) to investigate the causality between neuroticism clusters and female reproductive diseases. Instrumental variables were obtained from large-scale genome-wide association studies of populations of European descent involving three neuroticism clusters (depressed affect, worry, sensitivity to environmental stress, and adversity [SESA]) in the Complex Trait Genetics database and six female reproductive diseases (infertility, polycystic ovary syndrome [PCOS], spontaneous abortion, recurrent spontaneous abortion, endometriosis, and uterine fibroids) in the FinnGen database. The bidirectional two-sample MR analysis was conducted using the inverse variance-weighted, weighted median, and MR-Egger methods, whereas the sensitivity analysis was conducted using the Cochran's Q-test, MR-Egger intercept, and leave-one-out analysis. In the forward analysis, genetically predicted depressed affect and worry components of neuroticism significantly increased the risk of infertility (depressed affect: odds ratio [OR] = 1.399, 95% confidence interval [CI]: 1.054-1.856, p = 0.020; worry: OR = 1.587, 95% CI: 1.229-2.049, p = 0.000) and endometriosis (depressed affect: OR = 1.611, 95% CI: 1.234-2.102, p = 0.000; worry: OR = 1.812, 95% CI: 1.405-2.338, p = 0.000). Genetically predicted SESA component of neuroticism increased only the risk of endometriosis (OR = 1.524, 95% CI: 1.104-2.103, p = 0.010). In the reverse analysis, genetically predicted PCOS was causally associated with an increased risk of the worry component of neuroticism (Beta = 0.009, 95% CI: 0.003-0.016, p = 0.003). The MR study showed that the three neuroticism personality clusters had definite causal effects on at least one specific female reproductive disease. Moreover, PCOS may increase the risk of the worry component of neuroticism. This finding suggests the need to screen for specific female reproductive diseases in populations with high neuroticism and assess the psychological status of patients with PCOS.
Sections du résumé
BACKGROUND
BACKGROUND
The causality between neuroticism, a personality trait characterized by the tendency to experience negative emotions, and female reproductive diseases remains unclear. To provide evidence for the development of effective screening and prevention strategies, this study employed Mendelian randomization (MR) to investigate the causality between neuroticism clusters and female reproductive diseases.
METHODS
METHODS
Instrumental variables were obtained from large-scale genome-wide association studies of populations of European descent involving three neuroticism clusters (depressed affect, worry, sensitivity to environmental stress, and adversity [SESA]) in the Complex Trait Genetics database and six female reproductive diseases (infertility, polycystic ovary syndrome [PCOS], spontaneous abortion, recurrent spontaneous abortion, endometriosis, and uterine fibroids) in the FinnGen database. The bidirectional two-sample MR analysis was conducted using the inverse variance-weighted, weighted median, and MR-Egger methods, whereas the sensitivity analysis was conducted using the Cochran's Q-test, MR-Egger intercept, and leave-one-out analysis.
RESULTS
RESULTS
In the forward analysis, genetically predicted depressed affect and worry components of neuroticism significantly increased the risk of infertility (depressed affect: odds ratio [OR] = 1.399, 95% confidence interval [CI]: 1.054-1.856, p = 0.020; worry: OR = 1.587, 95% CI: 1.229-2.049, p = 0.000) and endometriosis (depressed affect: OR = 1.611, 95% CI: 1.234-2.102, p = 0.000; worry: OR = 1.812, 95% CI: 1.405-2.338, p = 0.000). Genetically predicted SESA component of neuroticism increased only the risk of endometriosis (OR = 1.524, 95% CI: 1.104-2.103, p = 0.010). In the reverse analysis, genetically predicted PCOS was causally associated with an increased risk of the worry component of neuroticism (Beta = 0.009, 95% CI: 0.003-0.016, p = 0.003).
CONCLUSIONS
CONCLUSIONS
The MR study showed that the three neuroticism personality clusters had definite causal effects on at least one specific female reproductive disease. Moreover, PCOS may increase the risk of the worry component of neuroticism. This finding suggests the need to screen for specific female reproductive diseases in populations with high neuroticism and assess the psychological status of patients with PCOS.
Identifiants
pubmed: 39267020
doi: 10.1186/s12905-024-03347-x
pii: 10.1186/s12905-024-03347-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
507Informations de copyright
© 2024. The Author(s).
Références
Digman JM. Higher-order factors of the Big Five. J Pers Soc Psychol. 1997;73(6):1246–56.
pubmed: 9418278
doi: 10.1037/0022-3514.73.6.1246
Canli T. Toward a neurogenetic theory of neuroticism. Ann N Y Acad Sci. 2008;1129:153–74.
pubmed: 18591477
doi: 10.1196/annals.1417.022
Lahey BB. Public health significance of neuroticism. Am Psychol. 2009;64(4):241–56.
pubmed: 19449983
pmcid: 2792076
doi: 10.1037/a0015309
Watson D, Clark LA, Harkness AR. Structures of personality and their relevance to psychopathology. J Abnorm Psychol. 1994;103(1):18–31.
pubmed: 8040477
doi: 10.1037/0021-843X.103.1.18
Eysenck SBG, Eysenck HJ, Barrett P. A revised version of the psychoticism scale. Personality Individ Differ. 1985;6(1):21–9.
doi: 10.1016/0191-8869(85)90026-1
Nagel M, Jansen PR, Stringer S, Watanabe K, de Leeuw CA, Bryois J, et al. Meta-analysis of genome-wide association studies for neuroticism in 449,484 individuals identifies novel genetic loci and pathways. Nat Genet. 2018;50(7):920–7.
pubmed: 29942085
doi: 10.1038/s41588-018-0151-7
Nagel M, Speed D, van der Sluis S, Østergaard SD. Genome-wide association study of the sensitivity to environmental stress and adversity neuroticism cluster. Acta Psychiatr Scand. 2020;141(5):476–8.
pubmed: 31972866
doi: 10.1111/acps.13155
Kendler KS, Kessler RC, Neale MC, Heath AC, Eaves LJ. The prediction of major depression in women: toward an integrated etiologic model. Am J Psychiatry. 1993;150(8):1139–48.
pubmed: 8328557
doi: 10.1176/ajp.150.8.1139
Clark LA, Watson D, Mineka S. Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol. 1994;103(1):103–16.
pubmed: 8040472
doi: 10.1037/0021-843X.103.1.103
Jokela M, Pulkki-Råback L, Elovainio M, Kivimäki M. Personality traits as risk factors for stroke and coronary heart disease mortality: pooled analysis of three cohort studies. J Behav Med. 2014;37(5):881–9.
pubmed: 24203126
doi: 10.1007/s10865-013-9548-z
Goodwin RD, Cox BJ, Clara I. Neuroticism and physical disorders among adults in the community: results from the National Comorbidity Survey. J Behav Med. 2006;29(3):229–38.
pubmed: 16724279
doi: 10.1007/s10865-006-9048-5
Niedzwiedz CL, Robb KA, Katikireddi SV, Pell JP, Smith DJ. Depressive symptoms, neuroticism, and participation in breast and cervical cancer screening: Cross-sectional and prospective evidence from UK Biobank. Psychooncology. 2020;29(2):381–8.
pubmed: 31663185
doi: 10.1002/pon.5272
Vukasović T, Bratko D. Heritability of personality: A meta-analysis of behavior genetic studies. Psychol Bull. 2015;141(4):769–85.
pubmed: 25961374
doi: 10.1037/bul0000017
Ormel J, Rijsdijk FV. Continuing change in neuroticism during adulthood—structural modelling of a 16-year, 5-wave community study. Personality Individ Differ. 2000;28(3):461–78.
doi: 10.1016/S0191-8869(99)00112-9
Roberts BW, Luo J, Briley DA, Chow PI, Su R, Hill PL. A systematic review of personality trait change through intervention. Psychol Bull. 2017;143(2):117–41.
pubmed: 28054797
doi: 10.1037/bul0000088
Edelmann RJ, Connolly KJ. Gender differences in response to infertility and infertility investigations: Real or illusory. Br J Health Psychol. 2000;5(4):365–75.
doi: 10.1348/135910700168982
Volgsten H, Ekselius L, Poromaa IS, Svanberg AS. Personality traits associated with depressive and anxiety disorders in infertile women and men undergoing in vitro fertilization treatment. Acta Obstet Gynecol Scand. 2010;89(1):27–34.
pubmed: 19947903
doi: 10.3109/00016340903447396
Cesta CE, Kuja-Halkola R, Lehto K, Iliadou AN, Landén M. Polycystic ovary syndrome, personality, and depression: A twin study. Psychoneuroendocrinology. 2017;85:63–8.
pubmed: 28825976
doi: 10.1016/j.psyneuen.2017.08.007
Barry JA, Hardiman PJ, Saxby BK, Kuczmierczyk A. Testosterone and mood dysfunction in women with polycystic ovarian syndrome compared to subfertile controls. J Psychosom Obstet Gynaecol. 2011;32(2):104–11.
pubmed: 21473679
doi: 10.3109/0167482X.2011.568129
Low WY, Edelmann RJ, Sutton C. A psychological profile of endometriosis patients in comparison to patients with pelvic pain of other origins. J Psychosom Res. 1993;37(2):111–6.
pubmed: 8463987
doi: 10.1016/0022-3999(93)90077-S
Hori S, Nakano Y, Furukawa TA, Ogasawara M, Katano K, Aoki K, et al. Psychosocial factors regulating natural-killer cell activity in recurrent spontaneous abortions. Am J Reprod Immunol. 2000;44(5):299–302.
pubmed: 11125793
doi: 10.1111/j.8755-8920.2000.440509.x
Boyko EJ. Observational research–opportunities and limitations. J Diabetes Complications. 2013;27(6):642–8.
pubmed: 24055326
doi: 10.1016/j.jdiacomp.2013.07.007
Richmond RC, Davey Smith G. Mendelian randomization: Concepts and scope. Cold Spring Harb Perspect Med. 2022;12(1):a040501.
Boef AG, Dekkers OM, le Cessie S. Mendelian randomization studies: a review of the approaches used and the quality of reporting. Int J Epidemiol. 2015;44(2):496–511.
pubmed: 25953784
doi: 10.1093/ije/dyv071
Kurki MI, Karjalainen J, Palta P, Sipilä TP, Kristiansson K, Donner KM, et al. FinnGen provides genetic insights from a well-phenotyped isolated population. Nature. 2023;613(7944):508–18.
pubmed: 36653562
pmcid: 9849126
doi: 10.1038/s41586-022-05473-8
Han X, Wu TQ, Bian Y, Chen L, Feng X. Psychological distress and uterine fibroids: a bidirectional two-sample mendelian randomization study. BMC Womens Health. 2024;24(1):351.
pubmed: 38890689
pmcid: 11184690
doi: 10.1186/s12905-024-03196-8
Yang X, Wang J, Hong H, Feng X, Zhang X, Song J. The association between diets and periodontitis: a bidirectional two-sample Mendelian randomization study. Front Genet. 2024;15:1398101.
pubmed: 38881793
pmcid: 11176517
doi: 10.3389/fgene.2024.1398101
Burgess S, Small DS, Thompson SG. A review of instrumental variable estimators for Mendelian randomization. Stat Methods Med Res. 2017;26(5):2333–55.
pubmed: 26282889
doi: 10.1177/0962280215597579
Chen H, Mi S, Zhu J, Jin W, Li Y, Wang T, et al. No causal association between adiponectin and the risk of rheumatoid arthritis: a Mendelian randomization study. Front Genet. 2021;12:670282.
pubmed: 34630505
pmcid: 8498100
doi: 10.3389/fgene.2021.670282
Dan YL, Wang P, Cheng Z, Wu Q, Wang XR, Wang DG, et al. Circulating adiponectin levels and systemic lupus erythematosus: a two-sample Mendelian randomization study. Rheumatology (Oxford). 2021;60(2):940–6.
pubmed: 32944772
doi: 10.1093/rheumatology/keaa506
Bowden J, Spiller W, Del Greco MF, Sheehan N, Thompson J, Minelli C, et al. Improving the visualization, interpretation and analysis of two-sample summary data Mendelian randomization via the Radial plot and Radial regression. Int J Epidemiol. 2018;47(4):1264–78.
pubmed: 29961852
pmcid: 6124632
doi: 10.1093/ije/dyy101
Pierce BL, Burgess S. Efficient design for Mendelian randomization studies: subsample and 2-sample instrumental variable estimators. Am J Epidemiol. 2013;178(7):1177–84.
pubmed: 23863760
pmcid: 3783091
doi: 10.1093/aje/kwt084
Bowden J, Davey Smith G, Haycock PC, Burgess S. Consistent estimation in mendelian randomization with some invalid instruments using a weighted median estimator. Genet Epidemiol. 2016;40(4):304–14.
pubmed: 27061298
pmcid: 4849733
doi: 10.1002/gepi.21965
Bowden J, Davey Smith G, Burgess S. Mendelian randomization with invalid instruments: effect estimation and bias detection through Egger regression. Int J Epidemiol. 2015;44(2):512–25.
pubmed: 26050253
pmcid: 4469799
doi: 10.1093/ije/dyv080
Greco MF, Minelli C, Sheehan NA, Thompson JR. Detecting pleiotropy in Mendelian randomisation studies with summary data and a continuous outcome. Stat Med. 2015;34(21):2926–40.
doi: 10.1002/sim.6522
Burgess S, Thompson SG. Interpreting findings from Mendelian randomization using the MR-Egger method. Eur J Epidemiol. 2017;32(5):377–89.
pubmed: 28527048
pmcid: 5506233
doi: 10.1007/s10654-017-0255-x
Hemani G, Bowden J, Davey SG. Evaluating the potential role of pleiotropy in Mendelian randomization studies. Hum Mol Genet. 2018;27(R2):R195-r208.
pubmed: 29771313
pmcid: 6061876
doi: 10.1093/hmg/ddy163
Bargiel-Matusiewicz K, Kroemeke A. Personality traits and coping styles in women with Mayer-Rokitansky-Küster-Hauser syndrome. Arch Med Sci. 2015;11(6):1244–9.
pubmed: 26788086
pmcid: 4697057
doi: 10.5114/aoms.2015.56350
Coşkuner Potur D, Onat G, Doğan MY. An evaluation of the relationship between violence exposure status and personality characteristics among infertile women. Health Care Women Int. 2019;40(11):1135–48.
pubmed: 31274387
doi: 10.1080/07399332.2019.1622704
Verhaak CM, Smeenk JM, Evers AW, van Minnen A, Kremer JA, Kraaimaat FW. Predicting emotional response to unsuccessful fertility treatment: a prospective study. J Behav Med. 2005;28(2):181–90.
pubmed: 15957573
doi: 10.1007/s10865-005-3667-0
Suls J, Martin R. The daily life of the garden-variety neurotic: reactivity, stressor exposure, mood spillover, and maladaptive coping. J Pers. 2005;73(6):1485–509.
pubmed: 16274443
doi: 10.1111/j.1467-6494.2005.00356.x
Liu Q, Zhou R, Oei TP, Wang Q, Zhao Y, Liu Y. Variation in the stress response between high- and low-neuroticism female undergraduates across the menstrual cycle. Stress. 2013;16(5):503–9.
pubmed: 23597234
doi: 10.3109/10253890.2013.797958
Garcia-Banda G, Chellew K, Fornes J, Perez G, Servera M, Evans P. Neuroticism and cortisol: pinning down an expected effect. Int J Psychophysiol. 2014;91(2):132–8.
pubmed: 24361230
doi: 10.1016/j.ijpsycho.2013.12.005
Joseph DN, Whirledge S. Stress and the HPA Axis: balancing homeostasis and fertility. Int J Mol Sci. 2017;18(10):2224.
Ghizzoni L, Mastorakos G, Vottero A, Barreca A, Furlini M, Cesarone A, et al. Corticotropin-releasing hormone (CRH) inhibits steroid biosynthesis by cultured human granulosa-lutein cells in a CRH and interleukin-1 receptor-mediated fashion. Endocrinology. 1997;138(11):4806–11.
pubmed: 9348209
doi: 10.1210/endo.138.11.5474
Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol. 2004;5(10):617–25.
pubmed: 15465465
doi: 10.1016/S1470-2045(04)01597-9
Zhang T, De Carolis C, Man GCW, Wang CC. The link between immunity, autoimmunity and endometriosis: a literature update. Autoimmun Rev. 2018;17(10):945–55.
pubmed: 30107265
doi: 10.1016/j.autrev.2018.03.017
Li XH, Ma YG, Geng LH, Qin L, Hu H, Li SW. Baseline psychological stress and ovarian norepinephrine levels negatively affect the outcome of in vitro fertilisation. Gynecol Endocrinol. 2011;27(3):139–43.
pubmed: 20670099
doi: 10.3109/09513590.2010.501871
Wu J, Kong S, Guo C, Wang J, Lu J, Jiang R, et al. An exaggerated epinephrine-adrenergic receptor signaling impairs uterine decidualization in mice. Reprod Toxicol. 2019;90:109–17.
pubmed: 31520687
doi: 10.1016/j.reprotox.2019.09.003
Long Q, Liu X, Qi Q, Guo SW. Chronic stress accelerates the development of endometriosis in mouse through adrenergic receptor β2. Hum Reprod. 2016;31(11):2506–19.
pubmed: 27664956
doi: 10.1093/humrep/dew237
Yoshino A, Kimura Y, Yoshida T, Takahashi Y, Nomura S. Relationships between temperament dimensions in personality and unconscious emotional responses. Biol Psychiatry. 2005;57(1):1–6.
pubmed: 15607293
doi: 10.1016/j.biopsych.2004.09.027
Nater UM, Hoppmann C, Klumb PL. Neuroticism and conscientiousness are associated with cortisol diurnal profiles in adults–role of positive and negative affect. Psychoneuroendocrinology. 2010;35(10):1573–7.
pubmed: 20299157
doi: 10.1016/j.psyneuen.2010.02.017
Roger D, Najarian B. The relationship between emotional rumination and cortisol secretion under stress. Pers Individ Diff. 1998;24(4):531–8.
Zobel A, Barkow K, Schulze-Rauschenbach S, Von Widdern O, Metten M, Pfeiffer U, et al. High neuroticism and depressive temperament are associated with dysfunctional regulation of the hypothalamic-pituitary-adrenocortical system in healthy volunteers. Acta Psychiatr Scand. 2004;109(5):392–9.
pubmed: 15049775
doi: 10.1111/j.1600-0447.2004.00313.x
Norris CJ, Larsen JT, Cacioppo JT. Neuroticism is associated with larger and more prolonged electrodermal responses to emotionally evocative pictures. Psychophysiology. 2007;44(5):823–6.
pubmed: 17596178
doi: 10.1111/j.1469-8986.2007.00551.x
Wilson GD, Kumari V, Gray JA, Corr PJ. The role of neuroticism in startle reactions to fearful and disgusting stimuli. Personality Individ Differ. 2000;29(6):1077–82.
doi: 10.1016/S0191-8869(99)00255-X
van Santen A, Vreeburg SA, Van der Does AJ, Spinhoven P, Zitman FG, Penninx BW. Psychological traits and the cortisol awakening response: results from the Netherlands Study of Depression and Anxiety. Psychoneuroendocrinology. 2011;36(2):240–8.
pubmed: 20724080
doi: 10.1016/j.psyneuen.2010.07.014
McCleery JM, Goodwin GM. High and low neuroticism predict different cortisol responses to the combined dexamethasone–CRH test. Biol Psychiatry. 2001;49(5):410–5.
pubmed: 11274652
doi: 10.1016/S0006-3223(00)01056-8
Chida Y, Hamer M. Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: a quantitative review of 30 years of investigations. Psychol Bull. 2008;134(6):829–85.
pubmed: 18954159
doi: 10.1037/a0013342
LeBlanc J, Ducharme MB. Influence of personality traits on plasma levels of cortisol and cholesterol. Physiol Behav. 2005;84(5):677–80.
pubmed: 15885243
doi: 10.1016/j.physbeh.2005.02.020
Oswald LM, Zandi P, Nestadt G, Potash JB, Kalaydjian AE, Wand GS. Relationship between cortisol responses to stress and personality. Neuropsychopharmacology. 2006;31(7):1583–91.
pubmed: 16407895
doi: 10.1038/sj.npp.1301012
Di Simplicio M, Costoloni G, Western D, Hanson B, Taggart P, Harmer CJ. Decreased heart rate variability during emotion regulation in subjects at risk for psychopathology. Psychol Med. 2012;42(8):1775–83.
pubmed: 22067596
doi: 10.1017/S0033291711002479
Ormel J, Bastiaansen A, Riese H, Bos EH, Servaas M, Ellenbogen M, et al. The biological and psychological basis of neuroticism: current status and future directions. Neurosci Biobehav Rev. 2013;37(1):59–72.
pubmed: 23068306
doi: 10.1016/j.neubiorev.2012.09.004
Susman EJ. Psychobiology of persistent antisocial behavior: stress, early vulnerabilities and the attenuation hypothesis. Neurosci Biobehav Rev. 2006;30(3):376–89.
pubmed: 16239030
doi: 10.1016/j.neubiorev.2005.08.002
Poppelaars ES, Klackl J, Pletzer B, Wilhelm FH, Jonas E. Social-evaluative threat: Stress response stages and influences of biological sex and neuroticism. Psychoneuroendocrinology. 2019;109:104378.
pubmed: 31382169
doi: 10.1016/j.psyneuen.2019.104378
Gold PW. The organization of the stress system and its dysregulation in depressive illness. Mol Psychiatry. 2015;20(1):32–47.
pubmed: 25486982
doi: 10.1038/mp.2014.163
Ortiz R, Gemmill JAL, Sinaii N, Stegmann B, Khachikyan I, Chrousos G, et al. Hypothalamic-pituitary-adrenal axis responses in women with endometriosis-related chronic pelvic pain. Reprod Sci. 2020;27(10):1839–47.
pubmed: 32572832
doi: 10.1007/s43032-020-00201-x
Urban W, Nizioł A, Pytlewski A, Zaborowska Ł, Dadański E, Rutkowski K, et al. Polycystic ovary syndrome: personality and temperamental characteristics. J Obstet Gynaecol Can. 2022;44(7):813–8.
pubmed: 35390518
doi: 10.1016/j.jogc.2022.03.011
Fliegner M, Richter-Appelt H, Krupp K, Brunner F. Sexual function and socio-sexual difficulties in women with Polycystic Ovary Syndrome (PCOS). Geburtshilfe Frauenheilkd. 2019;79(5):498–509.
pubmed: 31148850
pmcid: 6529231
doi: 10.1055/a-0828-7901
Alkheyr Z, Murad M, Das P, Aljenaee K, Kamel C, Hajji SA, et al. Self-esteem and body image satisfaction in women with PCOS in the Middle East: Cross-sectional social media study. PLoS ONE. 2024;19(4):e0301707.
pubmed: 38662709
pmcid: 11045070
doi: 10.1371/journal.pone.0301707
H AL, Szatkowski L, Gibson J, Fiaschi L, Bains M. Psychosocial impacts of infertility among omani women with polycystic ovarian syndrome: a qualitative study. Int J Fertil Steril. 2023;17(2):107–14.
Schmid J, Kirchengast S, Vytiska-Binstorfer E, Huber J. Infertility caused by PCOS–health-related quality of life among Austrian and Moslem immigrant women in Austria. Hum Reprod. 2004;19(10):2251–7.
pubmed: 15333601
doi: 10.1093/humrep/deh432
Xue K, Gao B, Chen F, Wang M, Cheng J, Zhang B, et al. Covariation of preadult environmental exposures, adult brain imaging phenotypes, and adult personality traits. Mol Psychiatry. 2023;28(11):4853–66.
Mumm H, Altinok ML, Henriksen JE, Ravn P, Glintborg D, Andersen M. Prevalence and possible mechanisms of reactive hypoglycemia in polycystic ovary syndrome. Hum Reprod. 2016;31(5):1105–12.
pubmed: 27008892
doi: 10.1093/humrep/dew046
McCrimmon RJ, Ewing FM, Frier BM, Deary IJ. Anger state during acute insulin-induced hypoglycaemia. Physiol Behav. 1999;67(1):35–9.
pubmed: 10463626
doi: 10.1016/S0031-9384(99)00036-0
McCrimmon RJ, Frier BM, Deary IJ. Appraisal of mood and personality during hypoglycaemia in human subjects. Physiol Behav. 1999;67(1):27–33.
pubmed: 10463625
doi: 10.1016/S0031-9384(99)00035-9
Damone AL, Joham AE, Loxton D, Earnest A, Teede HJ, Moran LJ. Depression, anxiety and perceived stress in women with and without PCOS: a community-based study. Psychol Med. 2019;49(9):1510–20.
pubmed: 30131078
doi: 10.1017/S0033291718002076
de Niet JE, de Koning CM, Pastoor H, Duivenvoorden HJ, Valkenburg O, Ramakers MJ, et al. Psychological well-being and sexarche in women with polycystic ovary syndrome. Hum Reprod. 2010;25(6):1497–503.
pubmed: 20356900
doi: 10.1093/humrep/deq068