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Mental health screening should accompany PCOS diagnosis
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Women with polycystic ovary syndrome are more likely to be diagnosed with mental health disorders, including depression, anxiety and bipolar disorder, than women without polycystic ovary syndrome, according to study data presented at the Society for Endocrinology BES annual conference.
“The effect of PCOS on mental health is under-appreciated,” Aled Rees, MD, PhD, FRCP, MAcadMEd, a reader with the Neurosciences & Mental Health Research Institute at Cardiff University, United Kingdom, said in a press release. “Our work shows that screening for mental health disorders should be considered during clinical assessments.”
Rees and colleagues analyzed data from 16,986 patients with PCOS, diagnosed between 2000 and 2014 and identified from the Clinical Practice Research Datalink. The cohort, followed for a minimum of 6 months, was matched to two control sets in a 1:1 ratio by age, BMI and primary care practice; control set 2 were additionally matched on prior mental health status. Primary outcomes were incidence of depression, anxiety and bipolar disorder; secondary outcomes were the prevalence of ADHD or autism spectrum disorder in offspring. Researchers used Cox proportional hazard models to compare the rates or progression to each primary outcome and logistic regression analysis to compare the prevalence of ADHD and autism spectrum disorder between groups.
Compared to control set 1, women with PCOS were more likely to experience depression (23.1% vs. 19.3%; P < .001), anxiety (11.5% vs. 9.3%; P < .001) and bipolar disorder (3.2% vs. 1.5%; P < .001), according to researchers. HRs for time to depression, anxiety and bipolar disorder endpoints were 1.26 (95% CI, 1.19-1.32), 1.2 (95% CI, 1.11-1.29) and 1.21 (95% CI, 1.03-1.42), respectively. HRs for time to depression, anxiety and bipolar disorder were higher when compared with control set 2, at 1.38 (95% CI, 1.3-1.45), 1.39 (95% CI, 1.29-1.51) and 1.44 (95% CI, 1.21-1.71), respectively.
When compared with control group 1, women with PCOS were also more likely to have a child with ADHD (HR = 1.54; 95% CI, 1.12-2.11) or autism spectrum disorder (HR = 1.64; 95% CI, 1.16-2.33). When compared with control group 2, the HR was higher for ADHD (HR = 1.76; 95% CI, 1.27-2.46) but lower for autism spectrum disorder (HR = 1.34; 95% CI, 0.96-1.89).
“Further research is needed to confirm the neurodevelopment effects of PCOS, and to address whether all or some types of patients with PCOS are exposed to mental health risks,” Rees said. – by Regina Schaffer
Reference:
Berni T, et al. P353. Presented at: Society for Endocrinology BES; Nov. 6-8, 2017; Harrogate, UK.
Disclosures: Rees reports no relevant financial disclosures.