Adverse Neurodevelopmental and Mental Health Outcomes in PCOS
Researchers performed a retrospective database analysis, matching 16,986 patients with PCOS to 2 control sets (1:1) by age, BMI, and primary care practice. Credit: BSIP/Science Source
Polycystic ovarian syndrome (PCOS) is associated with an increased risk for psychiatric morbidity, according to study results published in The Journal of Clinical Endocrinology & Metabolism. These data also indicated that children of women with PCOS are at an increased risk for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
Researchers performed a retrospective database analysis, matching 16,986 patients with PCOS to 2 control sets (1:1) by age, body mass index (BMI), and primary care practice. Control set 2 was also matched to mental health history.
As the primary outcome, investigators captured the incidence of depressive disorder, anxiety, bipolar disorder, schizophrenia, eating disorder, ADHD, and ASD in cases and controls. As the secondary end the point, researchers assessed the prevalence of ADHD and ASD in the children of mothers with PCOS.
In control set 1, 3912 (23.1%) patients with PCOS had previously been diagnosed with depression compared with 3272 (19.32%) controls (P <.00001). Compared with controls, patients with PCOS also had a higher incidence of prior anxiety (P <.00001), bipolar disorder (P <.00001), and eating disorder (P =.00003). The hazard ratios (95% CI) in patients with PCOS compared with controls in set 1 were 1.26 (1.19-1.32) for depression, 1.20 (1.11-1.29) for anxiety, 1.21 (1.03-1.42) for bipolar disorder, and 1.37 (1.05-1.81) for eating disorder. No significant differences in the prevalence of schizophrenia, ASD, or ADHD were observed between case and control groups.
In control set 2, patients with PCOS were still at an increased risk for psychiatric morbidity; hazard ratios were 1.38 (1.30-1.45) for depression, 1.39 (1.29-1.51) for anxiety, and 1.54 (1.16-2.05) for eating disorder. In control set 1, the rate of ADHD in children born to patients with PCOS was higher than the rate observed in children of controls (OR 1.64; 95% CI, 1.16-2.33). A similar effect was observed for ASD (OR 1.54; 95% CI, 1.12-2.11). In control set 2, increased incidence of both ADHD and ASD were observed in children of patients with PCOS, with odds ratios (95% CI) of 1.75 (1.27-2.46) and 1.34 (0.96-1.89), respectively.
These data confirmed the increased risk for psychiatric disorders in women with PCOS and indicated an increased risk for ADHD and ASD in their children. Researchers suggested that future studies investigate the mechanisms by which PCOS may increase these risks, and support routine mental health screening for this patient demographic.
Berni TR, Morgan CL, Berni ER, Rees DA. Polycystic ovary syndrome is associated with adverse mental health and neurodevelopmental outcomes [published online April 10, 2018]. J Clin Endocrinol Metab. doi:10.1210/jc.2017-02667