Changes in Mood, Anxiety, and Cognition with Polycystic Ovary Syndrome Treatment: A Longitudinal, Naturalistic Study

Abstract

Purpose

Individuals with polycystic ovary syndrome (PCOS) are at increased risk of depression and anxiety symptoms and impairment in aspects of cognitive function. However, there is little evidence regarding effects of standard treatment for PCOS on these features of the syndrome. The aim of this study was to examine the effect of 12 weeks of naturalistic treatment of PCOS, with usual medications, on depression symptoms, anxiety symptoms and cognitive function.

Patients and Methods

Thirty-three participants with PCOS received 12 weeks of individualised treatment based on clinical presentation. Changes in depression and anxiety symptoms were assessed with the self-report Hospital Anxiety and Depression Scale at baseline and 12 weeks, and cognitive function was assessed at the same time-points with a battery of tests spanning cognitive domains of verbal learning and memory, visuospatial learning and memory, psychomotor speed, attention and executive function. Outcomes were compared with a control group of 40 healthy participants.

Results

Participants with PCOS (mean age = 29.2 years; mean Body Mass Index = 27.4) were treated with a variety of medications, predominantly spironolactone (n = 22) and oral contraceptives (n = 16). Depression and anxiety symptoms improved significantly over the course of treatment, with moderate effect sizes (Cohen’s d 0.43–0.55, p < 0.05). Effect sizes of the difference in change from that of the control group were moderate but did not reach statistical significance. Women undergoing PCOS treatment demonstrated significant improvements in aspects of cognitive function, but improvement did not differ significantly from controls and effect size changes were similar, suggesting practise effects in both groups.

Conclusion

Our study provides preliminary evidence that treatment of PCOS may be associated with improvement in psychiatric aspects of the syndrome, particularly depressive symptoms.

Keywords:

• androgen
• depression
• cognitive function
• testosterone
• spironolactone

Acknowledgments

KMD was supported by a Sir Charles Hercus Health Research Fellowship from the Health Research Council of New Zealand (ref: 19/082) during completion of this paper.

Disclosure

RJP and KMD have used software provided by Scientific Brain Training Pro (SBT-Pro) for research at no cost. RJP has received support for travel to educational meetings from Servier and Lundbeck. The other authors have nothing to declare in this work.