Predictors of depression in women with polycystic ovary syndrome

Abstract

The aim of this study is to assess the prevalence and predictors of depressive symptoms in women with polycystic ovary syndrome (PCOS). In a cross-sectional study of 114 women seeking consultation for symptoms of PCOS (menstrual irregularity, hirsutism, and/or acne), personal and family history of depression (HD and FHD respectively) were enquired. Vitamin D status (n = 104) and manifest depressive symptoms assessed by personal health questionnaire (PHQ) (MD) were evaluated in a subset (85). Relationships between HD and MD with PCOS symptoms, FHD, and vitamin D status were assessed using adjusted analyses. Thirty-five percent acknowledged a HD; MD (PHQ > 4) was apparent in 43 %. HD was associated with hirsutism (OR 2.4, 95 % CI 1.01-5.9), disturbed sleep (OR 3.0, 95 % CI 1.3-6.9), and with FHD (OR 4.8, 95 % CI 1.7-13.5). Disturbed sleep (OR 2.4, 95 % CI 1.01-5.7) and FHD (OR 3.8, 95 % CI 1.3-11.2) were independent predictors of HD adjusting for race and BMI. An inverse correlation was noted between serum 25 OH vitamin D (25OHD) levels and PHQ score, but only in those with vitamin D deficiency (25OHD ≤ 30 ng/ml, n = 57, r =-0.32, p = 0.015). 25OHD < 20 ng/ml (OR 3.5, 95 % CI 1.1-11.8) and HD (OR 12.8, 95 % CI 3.6-45.2) predicted scoring in the highest PHQ tertile after adjusting for hirsutism, BMI, and race. In women with PCOS, disturbed nocturnal sleep and FDH predicted personal HD, whereas HD and vitamin D deficiency related to the severity of MD symptoms.

Sleep disturbances in women with polycystic ovary syndrome

“…The phenomenon was related to Moran et al (2015), but there are some other available data that indicate comorbidity of depressive and anxiety disorders with sleep disorders in women with PCOS [8]. Sleep disorders, as it occurs, might be the one of predictors of depression in women suffering from PCOS [24]. Among examined patients an excessive daytime sleepiness was observed, what is also reported in available literature [22,18].…”

Evaluation of affective temperament and anxiety–depression levels of patients with polycystic ovary syndrome

“…A previous meta-analysis highlighted that psychological distress is experienced by women affected by PCOS (Barry et al, 2011) and current studies demonstrate an increased prevalence of depressive symptoms and disorders (Legro et al, 2013). Women with PCOS are reported to experience depressive episodes approximately three times more frequently than healthy controls (HC) (Setji and Brown, 2014) and many explanations have been proposed for this relationship, such as negative body image associated with obesity, hirsutism, hyperandrogenism and acne, higher infertility rates and vitamin D deficiency (Stunkard et al, 2003;Weiner et al, 2004;Hollinrake et al, 2007;Adali et al, 2008;Kerchner et al, 2009;Bhattacharya and Jha, 2010;Jedel et al, 2010;Naqvi et al, 2015). All these factors could have an impact on depression in different ways in women with PCOS.…”

Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis

“…Women with PCOS may report clinically significant symptoms of anxiety or depression at least in part as a result of significant body changes imposed by their illness (eg, hirsutism, irregular menses, obesity, acne, hair thinning) 2,7. Previous research indicates that alterations in body image may contribute to psychological distress among women with PCOS 24…”

“…These symptoms can also contribute to psychological impairment 7. Despite the use of antidepressants in the treatment of depressive symptoms, there has been only one report to date on the use of serotonin reuptake inhibitors with a successful outcome in a patient with PCOS 8…”