Depression, anxiety, bipolar disorder all tied to hormonal condition Polycystic ovary syndrome (PCOS) may put women at a higher risk for mental health conditions, researchers reported. When compared with women without PCOS, those with the hormonal condition had a higher prevalence of several psychiatric-related conditions, including depression (23.1% versus 19.3%), anxiety (11.5% versus 9.3%), and bipolar disorder (3.2% versus 1.5%), according to Aled Rees, MBBCh, PhD, of Cardiff University in the U.K., and colleagues. Similarly, compared with matched controls, an adjusted model showed women with PCOS were more likely to develop one of these mental health conditions, the team reported online in the Journal of Clinical Endocrinology & Metabolism: Depression: HR 1.26 (95% CI 1.19 to 1.32) Anxiety: HR 1.20 (95% CI 1.11 to 1.29) Bipolar disorder: HR 1.21 (95% CI 1.03 to 1.42) Eating disorder: HR 1.37 (95% CI 1.05 to 1.81) The relationship with bipolar disorder held true even in a sensitivity analysis that excluded patients who had been treated with valproate therapy. However, there were no associations seen in regards to the risk of autism, attention deficit hyperactivity disorder (ADHD), and schizophrenia. "We weren't especially surprised by our findings as some previous work had suggested that patients with PCOS might be at increased risk of mental health disorders," Rees explained to MedPage Today. "There are many reasons why women with PCOS might suffer with depression and anxiety, including concerns in relation to body weight, fertility, hair growth, and menstrual disturbance, among others." The analysis included 16,986 patients appearing in the Clinical Practice Research Datalink in the U.K., who were diagnosed with PCOS in a primary care setting. These patients were then matched to controls without a history of PCOS, based upon age, body mass index (BMI), and primary care practice. Women with PCOS tended to have more primary care visits, a higher BMI, and elevated blood pressure. "We chose to undertake this study as previous work had suggested that women with PCOS might have an increased risk of mental health disorders," said Rees, noting that much of the prior research on this topic is limited and not very comprehensive. "By matching patients and control women carefully for BMI and age, and by accessing a large sample size -- approximately 17,000 patients -- we were able to study this question more effectively." In a subanalysis of children born to patients with PCOS and matched controls -- including a total of 17,847 births -- these offspring had a higher prevalence of both ADHD (HR 1.64, 95% CI 1.16 to 2.33) and autism spectrum disorder (HR 1.54, 95% CI 1.12 to 2.11) compared with children born to mothers without the condition. All relationships, including the associations with mental health conditions and neurodevelopmental conditions in offspring, held true when women were matched to another control group, further matched based by prior mental health status. Summing up, Rees recommended that healthcare providers with PCOS patients should consider screening for mental health disorders as part of the comprehensive evaluation of these patients. "Further research is needed to determine which components of the syndrome might be driving this increased risk, and indeed whether all patients with PCOS are at increased risk, or only some." Source
