Background
Polycystic Ovary Syndrome is a chronic and a common gynaecological condition impacting women of reproductive age. Women with PCOS have hormonal, ovulatory and metabolic dysfunction resulting in multiple symptoms. The correlation between hormonal disbalance and the impact on womens mental health has been researched for decades. However, the prevalence among different ethnicities has not been fully evaluated.
Methods
A systematic methodology was developed, and a protocol was published in PROSPERO CRD42020210863 and a systematic review of publications between 1st January 1990 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random effect models, subgroup analysis and sensitivity analysis.
Findings
We included 30 studies reporting on 3944 PCOS women. Majority of studies addressed depression anxiety, and common mental health. Studies had fair to poor methodological quality and includes observational studies and Randomised Clinical Trials. Overall, 17% 95% CI 7% to 29% of women with PCOS have clinical diagnosis of major or severe depression; 33% 95% CI 26% to 40% have elevated depressive symptoms or a clinical diagnosis of depression; 41% 95% CI 28% to 54% report anxiety symptoms, and 31% 95% CI 15% to 51% have a form a common mental health or are taking psychiatric medication for anxiety and / or depression. The use of various tools to assess mental health symptoms was among the reasons for the substantial heterogeneity across studies.
Interpretation
PCOS is associated with an increased risk of mental health disorders including depressives, anxiety, and other mental health disorders. While BAME populations account for about 20% of most of the samples studied, stratification by ethnicity was rarely attempted which made it difficult to elucidate the MH impact of PCOS on different communities.