Polycystic ovary syndrome (PCOS) is a common hormonal disorder, affecting about 10% of reproductive aged women. It is also the most common cause of infertility in younger women; however, many women are unaware they have PCOS until they experience problems with fertility. In our clinic, where we see women with mood and anxiety disorders, many women, probably more than the 10% observed in the general population, carry a diagnosis of PCOS. Does this mean that mood and anxiety disorders are more common in women with PCOS?
Previous studies have reported that women with PCOS may experience higher levels of anxiety or depressive symptoms than women without PCOS; however, these studies have observed symptoms which are relatively mild and typically within the normal range. What is not clear is whether these findings are clinically significant. In other words, is the prevalence of moderate and severe depression and anxiety symptoms higher in women with PCOS?
In order to answer this question, researchers conducted a comprehensive systematic review and meta-analysis which included 30 cross-sectional studies and at total of 3050 subjects with PCOS and 3858 controls, from 10 different countries.
Women with PCOS were more likely to report any depressive symptoms (OR: 3.78; 95% CI: 3.03-4.72; 18 studies) and more likely to report moderate to severe depressive symptoms (OR: 4.18; 95% CI: 2.68-6.52; 11 studies).
Women with PCOS were more likely to report any anxiety symptoms (OR: 5.62; 95% CI: 3.22-9.80, 9 studies) and more likely to report moderate to severe anxiety symptoms (OR: 6.55; 95% CI: 2.87, 14.93; 5 studies).
Because increased body mass index has been associated with increased risk for depression, the researchers analyzed the data when matching the subjects for BMI. In this analysis, women with PCOS still had higher odds of both depressive (OR: 3.25; 95% CI 1.73-6.09) and anxiety symptoms (OR: 6.30, 95% CI: 1.88-21.09).
This meta-analysis indicates that women diagnosed with PCOS experience a significant increase in risk of moderate to severe depression and anxiety symptoms, as compared to women without PCOS. These findings indicate that providers should consider screening women with PCOS for both depression and anxiety.
Ruta Nonacs, MD PhD
Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2017 May 1;32(5):1075-1091.