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

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.