Risk of developing major depressive disorder in polycystic ovary syndrome: a retrospective cohort study

Abstract

This study aimed to investigate the risk of developing major depressive disorder (MDD) in women with polycystic ovary syndrome (PCOS). As a population-based retrospective cohort study based on the Korean National Health Insurance Claims Database and National Health Information Database, newly diagnosed 26,251 women with PCOS with age matched 131,480 women without PCOS from 2007 to 2010 were followed longitudinally and the subsequent occurrence of newly onset MDD was evaluated. The risk of developing MDD in women with PCOS after adjusting for various confounding variables was higher compared to women without PCOS (hazard ratio [HR]1.34, 95% confidence intervals [CI] 1.29–1.40, p<.0001). Stratified by the body mass index, the risk of being admitted to the hospital due to MDD was the highest in the overweight PCOS (HR 2.53, 95% CI 1.71–3.76, p<.0001). The risk of developing MDD was higher in women with PCOS compared to women without PCOS. Maintenance of the appropriate body weight should be emphasised as the hazard ratio of developing MDD was higher in overweight women with PCOS.

Impact statement

• What is already known on this subject? PCOS is a multisystem disorder associated with various comorbidities including diabetes mellitus, infertility and endometrial cancer.

• What do the results of this study add? Women with PCOS showed a higher risk of developing MDD compared to age matched women without PCOS in this multivariate analysis after adjusting for body-mass-index, smoking habit, socio-economic status, residential area, blood glucose, and blood cholesterol. The risk of being admitted to hospital due to MDD was the highest in PCOS with BMI ≥ 25.

• What are the implications of these findings for clinical practice and/or further research? PCOS should not be considered as a condition confined to ovulatory dysfunction and dermatologic problems, but the higher risk of developing MDD should be recognised. The importance of maintaining an appropriate BMI should be emphasised, as the risk of being admitted to the hospital due to MDD increased in overweight and obese women with PCOS.

Keywords:

• Polycystic ovary syndrome
• major depressive disorder
• body mass index
• population-based study

Acknowledgements

The authors thank Dr. Jung Eun Song from the Department of Psychiatry, National Insurance Health Service Ilsan Hospital, for the expert advice on MDD.

Disclosure statement

There is no conflict of interest needed to be declared.

Author contributions

Study concept and design: In Ok Lee, Jong Wook Seo, Jae Eun Chung. Execution of data: Hae Yong Pak. Analysis and interpretation of data: Hae Yong Pak, Jae Eun Chung. Manuscript drafting: In Ok Lee, Jung Chul Kim, Jae Eun Chung. Critical discussion: In Ok Lee, Jong Wook Seo, Jae Eun Chung. Final approval of the version to be submitted: Jae Eun Chung.