Depression in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Dybciak, Paweł; Raczkiewicz, Dorota; Humeniuk, Ewa; Powrózek, Tomasz; Gujski, Mariusz; Małecka-Massalska, Teresa; Wdowiak, Artur; Bojar, Iwona

doi:10.3390/jcm12206446

Cited by 12 publications

(7 citation statements)

References 59 publications

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“…Almost two-thirds of participants had depression, anxiety, and stress. PCOS is known to increase mental health disorders [6,14,15]. The 2023 International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome recommended screening females with PCOS for anxiety and depression using regionally validated screening tools [2].…”

Section: Discussionmentioning

confidence: 99%

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Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia

Alnaeem,

Alnasser,

AlAli

et al. 2024

Cureus

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Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of childbearing age. It causes irregular menstruation, infertility, acne vulgaris, androgenic alopecia, and hirsutism. It is associated with a higher risk of mental disorders. This study aimed to determine the prevalence of depression and anxiety among females with PCOS and the factors associated with these disorders. Methods: This cross-sectional study was conducted between 15th January and 19th November 2023. We invited Saudi women to do an online survey. We sent the survey link privately, got their permission, and explained the research to ensure privacy and reliability. Females with a previous psychiatric history were excluded. Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to assess depression, anxiety, and distress. One-way analysis of variance (ANOVA) and two-sample t-tests were used to identify determinants of depression and anxiety. Results: About 967 females participated, of whom 474 (49%) were married, and 358 (37%) had a healthy weight. About 367 (37.9%) of participants were diagnosed with PCOS, and it was associated with age (26-35 years), divorce, and family history of PCOS (p < 0.05). About 112 (30.5%) of PCOS patients experienced extremely severe depression, and 144 (39.2%) had extreme anxiety. People in the age range of 15-25 years had a higher risk of depression and stress (p < 0.05). Divorced participants faced a higher risk of depression, anxiety, and stress than singles (p < 0.05). Those advised on diet and healthy lifestyles exhibited a higher risk of depression, anxiety, and stress than those who were not (p < 0.05). Additionally, being overweight was associated with a higher risk of depression (p < 0.05). Conclusion: The prevalence of PCOS was found to be 37.9% in our study, which may seem higher compared to the existing literature on PCOS. It is associated with being in the age group of 26-35 years, being divorced, and having a positive family history. Almost two-thirds of females with PCOS had depression, anxiety, and stress. Factors associated with the three disorders include divorce and management with diet and lifestyle modifications. Depression and stress were associated with young age. High body mass index (BMI) was associated with depression.

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Section: Discussionmentioning

confidence: 99%

“…PCOS also causes hyperandrogenism, leading to a higher concentration of testosterone [5]. It is associated with irregular menstruation, infertility, acne vulgaris, androgenic alopecia, and hirsutism [6].…”

Section: Introductionmentioning

confidence: 99%

Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia

Alnaeem,

Alnasser,

AlAli

et al. 2024

Cureus

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“…In addition to depression related to physiological sex hormone fluctuations, there have been many reports that some female reproductive diseases (PCOS, endometriosis, POI, etc.) with sex hormone abnormalities are also related to depression [ 18 , 89 , 90 ]. Dybcik et al showed a two-and-a-half times higher risk of depression in PCOS patients compared to healthy women in the recent meta-analysis of 4002 patients from 19 studies [ 89 ], and Allshouse et al reported that POI patients had an increased risk of depression [ 18 ].…”

Section: Is There Any Potential Role Of Vitamin D In Depression Relat...mentioning

confidence: 99%

“…with sex hormone abnormalities are also related to depression [ 18 , 89 , 90 ]. Dybcik et al showed a two-and-a-half times higher risk of depression in PCOS patients compared to healthy women in the recent meta-analysis of 4002 patients from 19 studies [ 89 ], and Allshouse et al reported that POI patients had an increased risk of depression [ 18 ].…”

Section: Is There Any Potential Role Of Vitamin D In Depression Relat...mentioning

confidence: 99%

The Associations of Vitamin D with Ovarian Reserve Markers and Depression: A Narrative Literature Review

Jeon

2023

Nutrients

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Since the identification of vitamin D receptors in both the female reproductive tract and the central nervous system, further data have shown that vitamin D is involved in the processes of reproductive and mental health. This paper reviews current research on the associations of vitamin D with ovarian reserve markers and depression and discusses the potential role of vitamin D in their relationships. There have been numerous studies reporting that vitamin D was significantly related to ovarian reserve markers and depression in basic or clinical research, but some observational and interventional clinical studies have shown inconsistent results. Nevertheless, recent meta-analyses of interventional studies have provided promising results showing that vitamin D supplementation significantly improves ovarian reserve metrics, especially in a subgroup of women with normal or diminished ovarian reserve, and decreases depressive symptoms and risk. The demonstration of an association of vitamin D with both ovarian reserve and depression could suggest that vitamin D may be another important key in explaining female reproductive depression. Larger-scale studies in standardized settings will be needed in order to gain further insight into the role of vitamin D in female reproduction and depression.

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“…Depression has been found to have associations with various female reproductive disorders. Its prevalence has been estimated to be approximately 31% in patients with PCOS 4 , ranging from 11% 5 to 27% 6 and 31.3% 7 in females with infertility, 15.6% in those with AUB 8 , 18.6% in individuals with spontaneous abortion 9 , and 27% in patients with ovarian cancer 10 . Moreover, it is noteworthy that depression presents a substantial risk element for the onset of gestational diabetes among expectant mothers, exhibiting a correlated augmented risk of 29% 11 .…”

Section: Introductionmentioning

confidence: 99%

Epidemiologic and genetic associations of female reproductive disorders with depression or dysthymia: a Mendelian randomization study

Ling,

Dai,

Weng

et al. 2024

Sci Rep

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Observational studies have previously reported an association between depression and certain female reproductive disorders. However, the causal relationships between depression and different types of female reproductive disorders remain unclear in terms of direction and magnitude. We conducted a comprehensive investigation using a two-sample bi-directional Mendelian randomization analysis, incorporating publicly available GWAS summary statistics. Our aim was to establish a causal relationship between genetically predicted depression and the risk of various female reproductive pathological conditions, such as ovarian dysfunction, polycystic ovary syndrome(PCOS), ovarian cysts, abnormal uterine and vaginal bleeding(AUB), endometriosis, leiomyoma of the uterus, female infertility, spontaneous abortion, eclampsia, pregnancy hypertension, gestational diabetes, excessive vomiting in pregnancy, cervical cancer, and uterine/endometrial cancer. We analyzed a substantial sample size, ranging from 111,831 to 210,870 individuals, and employed robust statistical methods, including inverse variance weighted, MR-Egger, weighted median, and MR-PRESSO, to estimate causal effects. Sensitivity analyses, such as Cochran's Q test, MR-Egger intercept test, MR-PRESSO, leave-one-out analysis, and funnel plots, were also conducted to ensure the validity of our results. Furthermore, risk factor analyses were performed to investigate potential mediators associated with these observed relationships. Our results demonstrated that genetic predisposition to depression or dysthymia was associated with an increased risk of developing PCOS (OR = 1.43, 95% CI 1.28–1.59; P = 6.66 × 10–11), ovarian cysts (OR = 1.36, 95% CI 1.20–1.55; P = 1.57 × 10–6), AUB (OR = 1.41, 95% CI 1.20–1.66; P = 3.01 × 10–5), and endometriosis (OR = 1.43, 95% CI 1.27–1.70; P = 2.21 × 10–7) after Bonferroni correction, but no evidence for reverse causality. Our study did not find any evidence supporting a causal or reverse causal relationship between depression/dysthymia and other types of female reproductive disorders. In summary, our study provides evidence for a causal relationship between genetically predicted depression and specific types of female reproductive disorders. Our findings emphasize the importance of depression management in the prevention and treatment of female reproductive disorders, notably including PCOS, ovarian cysts, AUB, and endometriosis.

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Depression in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Cited by 12 publications

References 59 publications

Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia

Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia

The Associations of Vitamin D with Ovarian Reserve Markers and Depression: A Narrative Literature Review

Epidemiologic and genetic associations of female reproductive disorders with depression or dysthymia: a Mendelian randomization study

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