Metabolic diseases and mental disorders in female subfertility: effectiveness of cognitive behavioral therapy intervention

Volodymyr Artyomenko; Dmytro Zhelezov; Daria Lahoda; Sergiy Derishov; Ganna Velichko; Victoria Kugel; Artem Baratiuk; Ioan Dumitru Suciu

Volodymyr Artyomenko Department of Obstetrics and Gynecology, Odesa National Medical University, Odesa, Ukraine
Dmytro Zhelezov Obstetrical and Labor Department, Odesa City Maternity Hospital No. 5, Odesa, Ukraine
Daria Lahoda Department of General Practice, Family Medicine and Outpatient Therapy, Odesa National Medical University, Odesa, Ukraine
Sergiy Derishov Department of Obstetrics and Gynecology, Odesa National Medical University, Odesa, Ukraine
Ganna Velichko Odesa Regional Medical Center for Mental Health, Odesa Regional Council, Odesa, Ukraine
Victoria Kugel Obstetrical and Labor Department, Odesa City Maternity Hospital No. 5, Odesa, Ukraine
Artem Baratiuk Department of Psychodiagnostics and Clinical Psychology, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
Ioan Dumitru Suciu Department of Obstetrics and Gynecology, Polizu Clinical Hospital, Alessandrescu-Rusescu National Institute for Mother and Child Health, Bucharest, Romania

Keywords: subfertility, metabolic syndrome, obesity, depression, anxiety, feeding and eating disorders

Abstract

Women with impaired fertility and metabolic disturbances often experience anxiety, depressive symptoms, emotional overeating, and dysfunctional beliefs related to body weight and self-image. This study evaluated the effectiveness of a structured cognitive behavioral therapy program in this patient group. A total of 609 women with metabolic disturbances were initially screened, including 314 women with primary or secondary subfertility; 240 eligible women aged 25–44 years were subsequently included in the prospective randomized controlled trial. Participants were randomized to standard care combined with a 12-week cognitive behavioral therapy program or to standard care alone. Psychological, behavioral, anthropometric, and laboratory parameters were assessed at baseline and after 12 weeks. The intervention group showed a greater reduction in depressive and anxiety symptoms than the control group. Cognitive behavioral therapy was also associated with fewer maladaptive automatic thoughts, reduced emotional overeating, increased physical activity, better dietary adherence, and moderate improvements in body mass index, waist circumference, glucose metabolism, and lipid profile. Cognitive behavioral therapy may be an effective component of interdisciplinary care for women with subfertility and metabolic disturbances.