Risk of depression and other mental health disorders in women with polycystic ovary syndrome: a longitudinal study

Objective: To determine the conversion risk and predictors for depression in women with polycystic ovary syndrome. Design: Prospective longitudinal study. Setting: University practice. Patient(s): Subjects with polycystic ovary syndrome who had participated in a previous study. Intervention(s): None. Main Outcome Measure(s): The Primary Care Evaluation of Mental Disorders Patient Health Questionnaire was used to diagnose major depressive disorder and other depressive syndromes, anxiety syndromes, and binge eating disorder. Subjects completed a questionnaire on knowledge about polycystic ovary syndrome and treatment satisfaction. Result(s): A total of 60 of 103 subjects responded to the second survey. Mean time between the two surveys was 22 months (range 12-26 months), The overall prevalence of depression was 40% (24/60). Of these, 10 women screened positive for major depressive disorder or other depressive syndromes and 14 were receiving antidepressant medications. There were 11 new cases identified in the second survey (19% conversion). Total subjects with mood disorders in this study were 34/60 (56.6%), including 11.6% with anxiety syndromes and 23.3% with binge eating disorder. Difficulties with menstrual function, fertility, and body image (weight, hirsutism, acne) were not significantly different in women with and without depression. Conclusion(s): There is a significant risk for mood disorders (defined by the Diagnostic and Statistical Manual of Mental Disorders-IV) in women with polycystic ovary syndrome. This finding together with a high conversion risk for depression over a 1- to 2-year period underscores the importance of routine screening and aggressive treatment of mental health disorders in this population. (Fertil Steril (R) 2009;91:207-12. (c) 2009 by American Society for Reproductive Medicine.)