Risk of Psychiatric Disorders following Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study

Abstract

BackgroundPolycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. A higher prevalence of psychiatric comorbidities, including depressive disorder, anxiety disorder, and bipolar disorder has been proved in patients with PCOS. However, a clear temporal causal relationship between PCOS and psychiatric disorders has not been well established.ObjectiveWe explored the relationship between PCOS and the subsequent development of psychiatric disorders including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder.MethodsWe identified patients who were diagnosed with PCOS by an obstetrician-gynecologist in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed of patients without PCOS who were matched according to age and sex. The occurrence of subsequent new-onset psychiatric disorders was evaluated in both cohorts based on diagnoses made by psychiatrists.ResultsThe PCOS cohort consisted of 5431 patients, and the comparison cohort consisted of 21,724 matched control patients without PCOS. The incidence of depressive disorder (hazard ratio [HR] 1.296, 95% confidence interval [CI] 1.084–.550), anxiety disorder (HR 1.392, 95% CI 1.121–1.729), and sleep disorder (HR 1.495, 95% CI 1.176–1.899) were higher among the PCOS patients than among the patients in the comparison cohort. In addition, a higher incidence of newly diagnosed depressive disorder, anxiety disorder, and sleep disorder remained significantly increased in all of the stratified follow-up durations (0–1, 1–5, ≥5 y).ConclusionsPCOS might increase the risk of subsequent newly diagnosed depressive disorder, anxiety disorder, and sleep disorder. The risk of newly diagnosed bipolar disorder, which has often been reported in the literature to be comorbid with PCOS, was not significantly elevated.

Morbidity and medicine prescriptions in a nationwide Danish population of patients diagnosed with polycystic ovary syndrome

“…The discrepancy between 1.4% patients diagnosed with depression and 16.3% patients treated with antidepressants could be explained by the fact that many patients are treated for depression by their own general practitioner and only hospital diagnoses are included in NPR. The present data support a moderately increased risk of depression in PCOS and are in agreement with recent studies (2,20,39). In contrast, some studies reported an up to eightfold increased risk of depression in PCOS (18), but treatment with antidepressants is only indicated in moderate or severe and psychotherapy should be used in patients with milder symptoms.…”

“…These results are supported by a recent register-based Taiwanese study reporting a hazard ratio of 1.4 for anxiety disorders in PCOS (39). Anxiety could be associated with depression and low quality of life in PCOS, but more studies are needed to test this hypothesis.…”

MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome

“…The use of anxiety medicine was higher in patients with PCOS compared with controls (7) and in a Taiwanese register-based study, the hazard ratio was 1.4 for anxiety disorders in PCOS (115). Anxiety could be associated with depression and low quality of life in PCOS, but more studies are needed to test this hypothesis.…”

Bak Foong pills combined with metformin in the treatment of a polycystic ovarian syndrome rat model

“…The characteristic clinical manifestation of this disease is its high heterogeneity, including high androgen, insulin resistance (IR) and glucose metabolism levels, thus the diagnosis and treatment remains difficult. PCOS at the childbearing age is the continuation of adolescent PCOS, which can increase the risks of cardiovascular system and glucose metabolism abnormalities in old age, as well as resulting in disorders of psychological and social cognition functions (2)(3)(4)(5)(6)(7). Therefore, the effective treatment of adolescent PCOS is of particular importance (8).…”