Research Article Open Access Volume 5 • Issue 2 • 1000228 J Depress Anxiety ISSN: 2167-1044 JDA an open access journal Open Access Review Article Journal of Depression & Anxiety J o u r n a l o f D e p r e s s i o n a n d A n x i e t y ISSN: 2167-1044 De Almeida et al., J Depress Anxiety 2016, 5:2 DOI: 10.4172/2167-1044.1000228 Keywords: Estrogen; Mood disorders; Anxiety disorders Introduction Te estrogen hormone is defned as being responsible for the control of ovulation and for the development of feminine characteristics. It works like a kind of energy supplement. It is a known fact that women are more likely to report symptoms of depression and anxiety during premenstrual, postpartum and perimenopausal periods, when estrogen levels are low [1,2]. Moreover, neuroimaging studies show greater activation of neural networks involved in fear when women are scanned during the early follicular phase of their menstrual cycle (low estrogen levels) than when they are scanned mid-cycle (high estrogen levels) [3,4]. Hence, natural fuctuations of estrogen across the reproductive cycle may factor into the disproportionate incidence of PTSD in women. Te explanation for clinical diferences observed between men and women might be seen, in part, in the structural and functional diferences of brain regions such as amygdala, hippocampus and medial prefrontal, which contain elevated levels of estrogen receptors. Studies show that women are twice as prone to sufering from fear and anxiety disorders [5-7]. Generalized anxiety, panic and post-traumatic stress disorders are highly prevalent in this female physiological framework. One reason for this is the diference in ovarian hormones which oscillate in women during their reproductive life and alter the emotional process [5]. Apparently, some women are more susceptible to hormonal changes, for example, during pre-menstrual periods, in the post-partum period and pre-menopause, as there is an alteration in the production of this hormone, enabling an increase or a reduction. Among these women a drastic reduction in estrogen levels may increase the risk of experiencing anxiety and symptoms of depression [6,7]. Furthermore, studies indicate that, as well as regulating the reproduction and modulation of sexual behaviour, estrogen also afects various other bodily systems such as the cardiovascular and musculoskeletal systems. It is highlighted in the research that estrogen can exercise an anti- infammatory efect on the brain [8,9]. Te objective of this study is to *Corresponding author: Izabel Barreto de Almeida, Institute of Psychiatry, Federal University of Rio de Janeiro, Laboratory of Panic and Respiration– INCT Translational Medicine, R Visconde de Pirajá, 407/702 - Rio de Janeiro – RJ – 22410-003, Brazil, Tel -5521-25216147; Fax -5521-25236839; E-mail: ibarretodealmeida@yahoo.com Received January 12, 2016; Accepted April 26, 2016; Published April 30, 2016 Citation: De Almeida IB, Nardi AE, De Ornelas Maia ACC, Levitan M (2016) Estrogen and Transdiagnostics: A Systematic Review. J Depress Anxiety 5: 228. doi:10.4172/2167-1044.1000228 Copyright: © 2016 De Almeida T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Estrogen and Transdiagnostics: A Systematic Review Izabel Barreto de Almeida 1,2 *, Antonio Egidio Nardi 1,2 , Ana Claudia Corrêa de Ornelas Maia 1,2 and Michelle Levitan 1,2 1 Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil 2 Laboratory of Panic and Respiration, INCT Translational Medicine, Brazil perform a systematic review, making reference to the scientifc literature on female patients with estrogen fuctuations which individuals infuence the occurrence, intensity, expression of diferent disorders of mood or anxiety (transdiagnostic). Sources Searches were carried out in the ISI Web of Science and PubMed databases, utilizing the terms “estrogen”, “anxiety disorder” and “mood disorder”. Te search was performed in May and June of 2015, with a temporal restriction of 10 years (2005-15) in both databases. Articles that were reviews or repeated were excluded, as were studies that were not available in English. Study Selection A total of 1060 references were found, 673 on PubMed and 387 on ISI Web of Science, among which 11 were duplicates and 52 were in languages other than English. Of the remaining 997 references, 118 were excluded by prior review, 114 for having incoherent abstracts, 727 by title and 20 by eligibility, leaving a total of 16 articles to compose this review. Te eligibility criteria were the hormone physiological relation with the prevalence of the anxiety and mood disorders. Abstract Objective: To evaluate, through systematic review, whether the role of estrogen infuences the onset of disorders in anxiety and depression. Data Sources: The search was performed in two databases, ISI Web of Science and PubMed, using the terms estrogen, anxiety and mood. Study selection: The search produced 1060 references. Those that were repeated or not written in English were excluded. After analysis of the abstracts, 38 were selected to have their texts read, of which 18 were chosen for the execution of this review. Data collection: The PubMed and ISI Web of Science articles were extracted in June 2015. Moreover, the study was also restricted to articles that involved adult patients and were elaborated between 2005 and 2015. Results: There were six case-control observational studies, followed by four randomized clinical trials. The results in smaller quantities in the review were: three retrospective cohort observational studies and three cross-sectional studies, followed by one prospective cohort observational study. A letter to an editor was also included. The result that stood out in the review was the fnding that women are twice as likely to suffer from disturbances of anxiety or mood, such as generalized anxiety disorder, panic disorder, post-traumatic stress disorder and bipolar disorder. Conclusion: Some women there is a greater vulnerability to hormonal oscillations of estrogen (in pre-menstrual and postpartum periods and in the pre-menopause) leading to the aforementioned disorders.