Study: Women with polycystic ovary syndrome face increased risk for suicide attempts

Key takeaways:

• Young adults had the highest HR for suicide attempt among all age groups, at 9.15.
• Physicians should vigilantly monitor the mental health of patients with PCOS, researchers said.

Women with polycystic ovary syndrome were at a more than eightfold risk for attempting suicide, with young adults particularly susceptible to risk, according to a study published in Annals of Internal Medicine.

According to the CDC, polycystic ovary syndrome (PCOS) affects 6% to 12% of women of reproductive age in the United States and can lead to diabetes, high blood pressure and stroke.

“Of note, persons diagnosed with PCOS face a heightened susceptibility to suicide attempts and self-harm compared with those without the condition,” Tien-Wei Hsu, MD, from the department of psychiatry at E-Da Dachang Hospital, in Taiwan, and colleagues wrote, although “evidence about the risk for suicide in persons diagnosed with PCOS remains inconclusive.”

In the study, Hsu and colleagues examined data from 18,960 women aged 12 to 64 years who were diagnosed with PCOS between 1997 and 2012. Each woman was then matched with control participants in a 1:10 ratio.
The researchers found that, overall, participants with PCOS had an 8.47-fold (95% CI, 7.54-9.51) increased risk for suicide attempts vs. the control group, even after adjusting for demographics, psychiatric comorbid conditions and all-cause clinical visits.

HRs across age groups were:

• 5.38 (95% CI, 3.93-7.37) among adolescents;
• 9.15 (95% CI, 8.03-10.42) among young adults; and
• 3.75 (95% CI, 2.23-6.28) among older adults.

The researchers added that the findings were still robust, even after excluding the first year or first 3 years of observation.

The risk for suicide among young adults with PCOS “may be related to the persistence of psychological distress, body dissatisfaction and reproductive concerns” in addition to unemployment and concerns regarding fertility, Hsu and colleagues wrote.

They suggested that the lower risk for suicide seen in adults with PCOS could be partially due to improved hormonal levels and clinical symptoms.

There were some limitations in the study, including a potential underestimation of the prevalence of PCOS and mental disorders.

Ultimately, the results underscore “the importance of clinician vigilance in monitoring the mental well-being and suicide risk of patients diagnosed with PCOS,” the researchers explained.

“Increased awareness and destigmatization of PCOS are essential in the general community and among girls and women,” they wrote. “Referral to a psychologist, psychiatrist or social worker for medical assistance or case management is recommended for patients at high risk for suicide.”

References:

• Hsu T, et al. Ann Intern Med. 2024;doi:10.7326/M23-2240.
• PCOS (polycystic ovary syndrome) and diabetes. https://www.cdc.gov/diabetes/basics/pcos.html. Accessed Feb. 2, 2023.