Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis

Figures & data

Figure 1 PRISMA flowchart of systematic review.

Abbreviations: PCOS, polycystic ovary syndrome; NIH, National Institutes of Health.

Table 1 Quality and characteristics of included studies

Study (year)	Location	Diagnostic criteria (PCOS)	Screening tool	Psychiatric diagnosis	NOS	Sample size	PCOS	PD and PCOS	CG	CG with PD	Age (PCOS group)	Age (control group)
Sahingöz et al,^Citation22 (2013)	Asia	NIH	DSM-IV	Depression	6	146	73	6	73	4	23.82 (4.99)	24.59 (4.71)
Sahingöz et al,^Citation22 (2013)	Asia	NIH	DSM-IV	Anxiety	6	146	73	8	73	1	23.82 (4.99)	24.59 (4.71)
Moran et al,^Citation20 (2012)	Oceania	NIH	HADS	Depression	6	56	29	9	27	3	32.00 (1.1)	36.4 (1.7)
Moran et al,^Citation20 (2012)	Oceania	NIH	HADS	Anxiety	6	56	29	19	27	12	32.00 (1.1)	36.4 (1.7)
Moran et al,^Citation21 (2010)	Oceania	Rotterdam	HADS	Depression	6	46	24	6	22	1	22.41 (0.39)	21.95 (0.47)
Moran et al,^Citation21 (2010)	Oceania	Rotterdam	HADS	Anxiety	6	46	24	9	22	2	22.41 (0.39)	21.95 (0.47)
Hollinrake et al,^Citation23 (2007)	North America	Rotterdam	BDI; PRIME-MD PHQ	Depression	7	206	103	22	103	3	29.2 (6.2)	30.7 (8.5)
Asik et al,^Citation19 (2015)	Asia	Rotterdam	HADS; TEMPS-A	Depression	6	120	70	30	50	7	23.08 (4.40)	24.96 (5.70)
Asik et al,^Citation19 (2015)	Asia	Rotterdam	HADS; TEMPS-A	Anxiety	6	120	70	25	50	6	23.08 (4.40)	24.96 (5.70)
Zueff et al,^Citation18 (2015)	South America	Rotterdam	HADS	Depression	7	87	44	22	43	22	30.1 (4.9)	32.6 (4.6)
Zueff et al,^Citation18 (2015)	South America	Rotterdam	HADS	Anxiety	7	87	44	13	43	8	30.1 (4.9)	32.6 (4.6)

Abbreviations: HADS, Hospital Anxiety and Depression Scale; TEMPS-A, Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire; PRIME-MD PHQ, Primary Care Evaluation of Mental Disorders Patient Health Questionnaire; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; BDI, Beck Depression Inventory; PD, psychiatric disorder; NIH, National Institutes of Health; PCOS, polycystic ovary syndrome; NOS, Newcastle–Ottawa Scale; CG, control group.

Figure 2 Forest plot of the studies assessing anxiety symptoms.

Abbreviation: RE model, random-effects model.

Figure 3 Funnel plot of the studies that assessed anxiety symptoms.

Table 2 Leave-one-out models for the meta-analysis of anxiety symptoms

Study (year)	Log odds ratio	SE	z value	P-value	95% Cl	Heterogeneity
						Q statistic (P-value)	τ^2	I^2
Sahingöz et al,^Citation22 (2013)	0.874	0.410	2.128	P=0.033	0.069 to 1.679	6.686 (P=0.082)	0.357	54.2%
Moran et al,^Citation20 (2012)	1.119	0.530	2.111	P=0.034	0.080 to 2.158	8.342 (P=0.039)	0.658	62.3%
Moran et al,^Citation21 (2010)	0.887	0.435	2.039	P=0.041	0.034 to 1.739	6.970 (P=0.072)	0.403	55.8%
Asik et al,^Citation19 (2015)	0.925	0.500	1.849	P=0.064	−0.055 to 1.906	6.610 (P=0.085)	0.529	55.4%
Zueff et al,^Citation18 (2015)	1.343	0.324	4.146	P<0.001	0.708 to 1.979	1.656 (P=0.646)	0	0%

Abbreviations: SE, standard error; CI, confidence interval.

Figure 4 Forest plot of the studies that assessed depressive symptoms.

Abbreviation: RE model, random-effects model.

Figure 5 Funnel plot of the studies that assessed depressive symptoms.

Table 3 Leave-one-out models for the meta-analysis of depressive symptoms

Excluded study (year)	Log odds ratio	SE	z value	P-value	95% CI	Heterogeneity
						Q statistic (P-value)	τ^2	I^2
Sahingöz et al,^Citation22 (2013)	1.401	0.313	4.477	P<0.001	0.788 to 2.015	4.331 (P=0.363)	0.097	19.6%
Moran et al,^Citation20 (2012)	1.258	0.349	3.598	P<0.001	0.572 to 1.943	6.052 (P=0.195)	0.215	35.9%
Moran et al,^Citation21 (2010)	1.209	0.312	3.864	P<0.001	0.595 to 1.822	5.649 (P=0.226)	0.142	29.1%
Hollinrake et al,^Citation23 (2007)	1.065	0.276	3.851	P<0.001	0.523 to 1.607	3.340 (P=0.502)	0.002	0.4%
Asik et al,^Citation19 (2015)	1.179	0.375	3.144	P=0.001	0.444 to 1.914	5.562 (P=0.234)	0.225	32.4%
Zueff et al,^Citation18 (2015)	1.451	0.295	4.914	P<0.001	0.872 to 2.030	3.997 (P=0.406)	0.011	2.4%

Abbreviations: SE, standard error; CI, confidence interval.

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