Increased risk of depressive disorders in women with polycystic ovary syndrome

Hollinrake, Elizabeth; Abreu, Alison; Maifeld, Michelle; Van Voorhis, Bradley J.; Dokras, Anuja

doi:10.1016/j.fertnstert.2006.11.039

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Volume 87, Issue 6 , Pages 1369-1376, June 2007

Increased risk of depressive disorders in women with polycystic ovary syndrome

Presented at the 61st Annual Meeting of the American Society of Reproductive Medicine, October 2005.

Elizabeth Hollinrake, B.S.
- Department of Obstetrics and Gynecology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
Alison Abreu, M.D.
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
Michelle Maifeld, R.N.C.
- Department of Obstetrics and Gynecology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
Bradley J. Van Voorhis, M.D.
- Department of Obstetrics and Gynecology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
Anuja Dokras, M.D.
- Department of Obstetrics and Gynecology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Reprint requests: Anuja Dokras, M.D., Ph.D., Department of Obstetrics and Gynecology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 (FAX: 319-335-6659).

Received 8 March 2006; received in revised form 7 November 2006; accepted 7 November 2006. published online 31 March 2007.

Objective

Polycystic ovary syndrome (PCOS) is associated with several metabolic complications. A few small studies have also suggested an increased risk of depression in women with PCOS. The goals of this study were to estimate the prevalence of depressive disorders in women with PCOS compared with controls and to evaluate the correlation between depression, hyperandrogenism, and other metabolic markers.

Design

Cohort study.

Setting

University Hospital.

Patient(s)

Women with PCOS (Rotterdam criteria; n = 103). Women without PCOS seen during the same time period for an annual exam were used as control subjects (n = 103).

Intervention(s)

Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PRIME-MD PHQ) and the Beck Depression Inventory.

Main Outcome Measure(s)

Depressive disorders.

Result(s)

Women with PCOS were at an increased risk for depressive disorders (new cases) compared with controls (21% vs. 3%; odds ratio 5.11 [95% confidence interval (CI) 1.26–20.69]; P<.03). The overall risk of depressive disorders in women with PCOS was 4.23 (95% CI 1.49–11.98; P<.01) independent of obesity and infertility. Compared with the nondepressed PCOS subjects, the depressed PCOS subjects had a higher body mass index (BMI) and evidence of insulin resistance (P<.02).

Conclusion(s)

We report a significantly increased risk of depressive disorders (as defined by the Diagnostic and Statistical Manual IV) in women with PCOS and recommend routine screening in this population.

Key Words: Polycystic ovary syndrome, depression, mood disorders, obesity