Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index

Jedel, Elizabeth; Wærn, Margda; Gustafson, Deborah; Landén, Mikael; Eriksson, Elias; Holm, Göran; Nilsson, Lars; Lind, Anna-Karin; Janson, Per-Olof; Stener-Victorin, Elisabet

doi:10.1093/humrep/dep384

Cited by 148 publications

(117 citation statements)

References 39 publications

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“…Many studies evaluating mental health are limited by the fact that psychiatric disorders may be underdiagnosed or treated in an outpatient setting and therefore excluded from evaluation when hospital admissions are used as inclusion criteria [5]. Based on the studies included, a majority of patients with subsequent mental health challenges appear to have a diagnosis of PCOS [1][2][3][4]6]. The relationship between PCOS and mental health is not yet clear but may be independent of a strict diagnosis of infertility.…”

Section: Discussionmentioning

confidence: 99%

“…Universally, authors concluded that women with a history of infertility or an infertility-related diagnosis, specifically PCOS, were at increased risk to develop mental health disorders [1][2][3][4][5][6]. Four out of the six studies that found correlations with mental health issues used women with PCOS as their primary population [2][3][4]6]. Depression risk was found to be elevated in four out of the six studies based on scores from validated scales such as the Edinburgh Depression Scale [1][2][3]6].…”

Section: Infertility and Mental Healthmentioning

confidence: 99%

“…Depression risk was found to be elevated in four out of the six studies based on scores from validated scales such as the Edinburgh Depression Scale [1][2][3]6]. Five of the six studies noted significant increases in diagnoses of anxiety or psychosocial distress in the specific study populations [1][2][3][4]6].…”

Section: Infertility and Mental Healthmentioning

confidence: 99%

“…Results Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1][2][3][4][5][6][7][8][9][10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7,8,[10][11][12][13][14][15][16][17][18][19][20].…”

mentioning

confidence: 99%

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Female infertility, infertility-associated diagnoses, and comorbidities: a review

Hanson

Johnstone

Dorais

et al. 2016

J Assist Reprod Genet

199

135

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Purpose The purpose of the study is to evaluate existing literature for possible associations between female infertility, infertility-associated diagnoses, and the following areas of disease: psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Methods The design of the study is a literature review. The patients were women included in 26 selected studies due to a diagnosis of infertility or a reproductive disorder associated with infertility. This study has no interventions, and the main outcome measure is the association between female infertility or a related diagnosis and psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Results Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1][2][3][4][5][6][7][8][9][10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7,8,[10][11][12][13][14][15][16][17][18][19][20]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardioCapsule There is a growing body of literature addressing the impact of female infertility on long-term health. This review evaluates 26 studies, investigating possible correlations between infertility and psychiatric illness, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Overall, higher rates of psychiatric illness and endometrial cancer were seen in infertile women. It is unclear whether infertility results in increased rates of breast cancer and ovarian cancer, and data are conflicting regarding correlations between generalized infertility and cardiovascular disease and metabolic dysfunction. This study summarizes current literature and can guide practitioners in counseling infertile patients.

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Section: Discussionmentioning

confidence: 99%

Section: Infertility and Mental Healthmentioning

confidence: 99%

Section: Infertility and Mental Healthmentioning

confidence: 99%

mentioning

confidence: 99%

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Female infertility, infertility-associated diagnoses, and comorbidities: a review

Hanson

Johnstone

Dorais

et al. 2016

J Assist Reprod Genet

199

135

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“…Few respondents were concerned about psychosocial problems despite the increasing evidence that psychological symptoms can negatively affect patients with PCOS and may have significant implications for their quality of life. The physical characteristics of PCOS can cause stress and increase the risk for depression (35) and anxiety disorders (36,37). A poorer perception of their quality of life has also been related to a more severe phenotype of women affected by this disorder (38,39).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire

Conway¹,

Dewailly²,

Diamanti-Kandarakis³

et al. 2014

European Journal of Endocrinology

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Background: There is evidence for differences between endocrinologists and other specialists in their approach to diagnosis and management of the polycystic ovary syndrome (PCOS). Objective: A mailed survey consisting of a simple questionnaire aiming to understand current practice for diagnosis and management of the PCOS by specialists across Europe. Methods: The questionnaire consisted of 23 questions grouped to achieve information on i) the general characteristics of the respondents, ii) patients with PCOS seen by endocrinologists, iii) the main diagnostic criteria, iv) biochemical parameters used in the differential diagnosis of hyperandrogenism, v) long-term concerns, and, finally vi) treatment choices. A total of 357 questionnaires representing 13.3% of the members of European Society of Endocrinology (ESE) were available for final analysis; 93% of the respondents were endocrinologists Results: In relation to the diagnostic criteria, respondents were most likely to select menstrual irregularity as the most frequent criteria used for the diagnosis of PCOS although very high rates were achieved for the use of hirsutism and biochemical hyperandrogenism. It therefore appears that the NIH criteria were followed by the majority of respondents. The most frequent biochemical parameters in the differential diagnosis of hyperandrogenism were total testosterone or free androgen index. Obesity and type 2 diabetes were regarded as the principal long-term concerns for PCOS. The most common treatments for patients with PCOS were metformin (33%), lifestyle modification (25%), and oral contraceptives (22%). More direct treatments of infertility include clomiphene citrate alone or in combination with metformin, prescribed by 9 and 23%, respectively, whereas only 6% used other methods for induction of ovulation.

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Association Between Mental Health and Reproductive System Disorders in Women

et al. 2023

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ImportanceReproductive system and mental health disorders are commonly comorbid in women. Although the causes of this overlap remain elusive, evidence suggests potential shared environmental and genetic factors associated with risk.ObjectiveTo investigate the comorbidity between psychiatric and reproductive system disorders, both as broad diagnostic categories and among specific pairs of diagnoses.Data SourcePubMed.Study SelectionObservational studies published between January 1980 and December 2019 assessing prevalence of psychiatric disorders in women with reproductive system disorders and prevalence of reproductive system disorders in women with psychiatric disorders were included. The study did not include psychiatric and reproductive disorders triggered by life events (eg, trauma, infection, surgery) to address potential confounding.Data Extraction and SynthesisA search yielded 1197 records, of which 50 met the inclusion criteria for the qualitative and 31 for the quantitative synthesis in our study. A random-effects model was used for data synthesis and Egger test and I2 to assess study bias and heterogeneity. Data were analyzed from January to December 2022. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline.Main Outcomes and MeasuresPsychiatric and reproductive system disorders.ResultsA total of 1197 records were identified, of which 50 met the inclusion criteria for qualitative and 31 for quantitative synthesis. Diagnosis of a reproductive system disorder was associated with a 2- to 3-fold increased odds of having a psychiatric disorder (lower bound odds ratio [OR], 2.00; 95% CI, 1.41-2.83; upper bound OR; 2.88; 95% CI, 2.21-3.76). The analysis focused on specific diagnoses described in the literature and found that polycystic ovary syndrome was associated with increased odds of depression (population-based studies OR, 1.71; 95% CI, 1.19-2.45; clinical studies OR, 2.58; 95% CI, 1.57-4.23) and anxiety (population-based studies OR, 1.69; 95% CI, 1.36-2.10; clinical studies OR, 2.85; 95% CI, 1.98-4.09). Chronic pelvic pain was also associated with both depression (OR, 3.91; 95% CI, 1.81-8.46) and anxiety (OR, 2.33; 95% CI, 1.33-4.08). Few studies investigated risk of other reproductive system disorders in women with psychiatric disorders, or reverse associations (risk of reproductive system disorder among women with a psychiatric diagnosis).Conclusions and RelevanceIn this systematic review and meta-analysis, a high rate of reported co-occurrence between psychiatric and reproductive disorders overall was observed. However, data for many disorder pairs were limited. The available literature focused overwhelmingly on affective disorders in polycystic ovary syndrome, overlooking a substantial portion of disease overlap. As such, the associations between the majority of mental health outcomes and conditions of the female reproductive system are largely unknown.

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Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index

Abstract: Several anxiety symptoms distinguished women with PCOS from a control group matched on BMI. A better understanding of the symptoms is needed to identify and alleviate anxiety symptoms in this vulnerable group.

Cited by 148 publications

References 39 publications

Female infertility, infertility-associated diagnoses, and comorbidities: a review

Female infertility, infertility-associated diagnoses, and comorbidities: a review

European survey of diagnosis and management of the polycystic ovary syndrome: results of the ESE PCOS Special Interest Group's Questionnaire

Association Between Mental Health and Reproductive System Disorders in Women

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