Androgen Excess- Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome

Dokras, Anuja; Stener-Victorin, Elisabet; Yildiz, Bülent O.; Li, Rong; Ottey, Sasha; Shah, Duru; Epperson, Neill; Teede, Helena

doi:10.1016/j.fertnstert.2018.01.038

Cited by 208 publications

(195 citation statements)

References 88 publications

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“…In our study population, there were no observed sociodemographic differences between women with and without PCOS, but PCOS was associated with more risk factors for perinatal mental disorders. We observed high prevalence of pre-existing depression and anxiety in women reporting PCOS compared with women not reporting PCOS and this supports mental health disorders as an integral component of PCOS [40,50]. We also observed that infertility, fertility treatment and miscarriage were more common in women reporting PCOS.…”

Section: Discussionsupporting

confidence: 75%

“…It is associated with a wide range of reproductive (menstrual irregularity, anovulation), endocrine (impaired glucose tolerance, type 2 diabetes) and metabolic (metabolic syndrome, fatty liver, increased cardiovascular risk factors) complications [34][35][36][37][38]. Mental health disorders such as depression, anxiety and eating disorders are prevalent in women with PCOS and psychological screening is advocated by the latest International evidence-based guideline for the assessment and management of PCOS [39,40]. PCOS is also the most common cause of anovulatory infertility with up to 70% of women with PCOS experiencing infertility and nearly 90% of them seeking fertility treatment [41].…”

Section: Introductionmentioning

confidence: 99%

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Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort

Tay

Teede

Boyle

et al. 2019

JCM

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Women with polycystic ovary syndrome (PCOS) have many risk factors associated with perinatal mental disorders, but research in this area is scarce. This study aims to compare the prevalence of common perinatal mental disorders in women with and without PCOS, and examine the relationship between PCOS and common perinatal mental disorders. We performed a cross-sectional study on self-reported data of 5239 women born between 1973 to 1978 in the Australian Longitudinal Study on Women's Health. Compared with women not reporting PCOS, women reporting PCOS had higher prevalence of antenatal depression (8.9% vs. 4.4%, p < 0.001), antenatal anxiety (11.7% vs. 5.6%, p < 0.001), postnatal depression (26.8% vs. 18.6%, p < 0.001) and postnatal anxiety (18.4% vs. 12.0%, p < 0.001). PCOS was positively associated with antenatal depression and/or anxiety (adjusted odds ratio 1.8, 95% confidence interval 1.2-2.6) but not postnatal depression and/or anxiety after controlling for sociodemographic and lifestyle factors, reproductive history, obstetric complications and pre-existing depression and anxiety. General perinatal guidelines currently do not recognize PCOS as a risk factor and the international evidence based PCOS guideline noted inadequate evidence in this area. This paper addresses the gap in literature and highlights the need to screen for common perinatal mental disorders in women with PCOS.

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Section: Discussionsupporting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort

Tay

Teede

Boyle

et al. 2019

JCM

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“…The results are in contrast with a metaanalysis, which concluded that that key domains were hirsutism, menstruation and infertility. 19 However, in other studies weight gain had the greatest negative influence on QoL in PCOS with mean PCOSQ weight scores reported as low as 2.85. 20 Similar results were observed in our study where BMI had negative impact on weight and infertility domains of PCOSQ (Table 2).…”

Section: Discussionmentioning

confidence: 86%

Prevalence of depression and quality of life in polycystic ovary syndrome patients at a tertiary care hospital: a cross-sectional study

Gollapudi

Lanke

Namilakoda

2019

Int J Reprod Contracept Obstet Gynecol

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prevalence is about 3.7%-22.5% as reported by the Indian Fertility Society in 2014. 5 The pathophysiology of PCOS is completely not understood. Several theories have been proposed to explain the pathogenesis of PCOS. 6• An alteration in gonadotropin-releasing hormone secretion results in increased luteinizing hormone (LH) secretion. ABSTRACTBackground: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathy among women of reproductive age. Physical symptoms in PCOS cause depression and decrease the Quality of Life (QoL). The objective was to study the prevalence of depression in women suffering from PCOS and to assess its correlation with QoL.Methods: This was a cross sectional study conducted among one hundred patients diagnosed with PCOS. Women 18-40 years of age diagnosed with PCOS were included in the study. Patients with known psychiatric illness were excluded. Depression severity was assessed with Hamilton depression (HAM-D) scale. The quality of life (QoL) was assessed with Polycystic ovary syndrome questionnaire (PCOSQ). The data was analyzed using the SPSS for Windows, Version 25.0; Chicago, SPSS Inc. Results: The mean age and BMI was 25.64±3.25 years and 26.78±2.72 kg/m 2 respectively. The mean depression score was 12.46±6.18. QoL domains showed that the lowest score was in the menstrual problem with a mean of 12.48±4.44 and the highest was in the emotional domain with a mean of 28.07±11.17. The negative correlations were between age and Hamilton score (p < 0.05). The Hamilton score was negatively correlated with the emotional score (p <0.01) and weight score was positively correlated with infertility score (p <0.01). Conclusions: PCOS was clearly associated with depression and reduced QoL. This should warrant health professionals to consider routine screening for depression and assess the impact of symptoms on their QoL to improve patient outcomes.

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“… 7 PCOS has significant psychological impact with increased depression and anxiety and impaired quality of life (Box 2). 8 , 9 There is also an increased rate of weight gain and prevalence of obesity in PCOS, increasing severity of the condition, causing considerable concern for those affected and mandating attention to healthy lifestyle 10 …”

Section: Boxmentioning

confidence: 99%

Translation and implementation of the Australian‐led PCOS guideline: clinical summary and translation resources from the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Teede

Misso

Boyle

et al. 2018

Medical Journal of Australia

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Introduction: We have developed the first international evidence‐based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian‐led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will enable practice benchmarking and feedback to further inform evidence‐based practice. We propose that this methodology could be used in developing and implementing guidelines for other women's health conditions and beyond. Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non‐fertility indications; and assessment and treatment of infertility. Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow‐up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple pregnancies compared with clomiphene citrate.

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Androgen Excess- Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome

Cited by 208 publications

References 88 publications

Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort

Perinatal Mental Health in Women with Polycystic Ovary Syndrome: A Cross-Sectional Analysis of an Australian Population-Based Cohort

Prevalence of depression and quality of life in polycystic ovary syndrome patients at a tertiary care hospital: a cross-sectional study

Translation and implementation of the Australian‐led PCOS guideline: clinical summary and translation resources from the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

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