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Increased Risk for Abnormal Depression Scores in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Dokras, Anuja MD, PhD; Clifton, Shari MLS; Futterweit, Walter MD; Wild, Robert MD, PhD

doi: 10.1097/AOG.0b013e318202b0a4

OBJECTIVE: Polycystic ovary syndrome (PCOS) and depression both have a high prevalence in reproductive-aged women. This study aimed to determine the prevalence of abnormal depression scores in women who meet currently recognized definitions of PCOS compared with women in a well-defined control group.

DATA SOURCES: The search was performed in MEDLINE, EMBASE Classic plus EMBASE, PsycINFO, Current Contents-Clinical Medicine and Current Contents-Life Sciences and Web of Science. Cochrane software Review Manager 5.0.24 was used to construct forest plots comparing risk of abnormal depression scores in those in the PCOS and control groups.

METHODS OF STUDY SELECTION: Studies with well-defined criteria of women with PCOS and control groups of women without PCOS, with demographic information including age and body mass index (BMI), were included. Of 752 screened articles, 17 met the selection criteria for systematic review and 10 studies were included in the meta-analysis.

TABULATION, INTEGRATION, AND RESULTS: Data were abstracted independently by three reviewers. All studies were cross-sectional and most used the Rotterdam criteria for the diagnosis of PCOS (n=10). The odds ratio (OR) for abnormal depression scores was 4.03 (95% confidence interval [CI] 2.96–5.5, P<.01) in women with PCOS (n=522) compared with those in the control groups (n=475). A subanalysis showed that the odds for abnormal depression scores was independent of BMI (OR 4.09, 95% CI 2.62–6.41). Several validated tools were used to screen for depression; the common tool used was the Beck Depression Inventory.

CONCLUSION: The results of our study suggest the need to screen all women with PCOS for depression using validated screening tools. Women with PCOS are at an increased risk for abnormal depression scores independent of BMI.

Young women with well-defined polycystic ovary syndrome have a fourfold increased risk for abnormal depression scores compared with control groups of women without polycystic ovary syndrome.

From the University of Pennsylvania, Philadelphia, Pennsylvania; the Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma; and the Mount Sinai School of Medicine, New York, New York.

See related editorial on page 1 and related article on page 6.

Presented in part at the Androgen Excess & PCOS Society meeting, June 9, 2009, Washington, DC.

Corresponding author: Anuja Dokras, 3701 Market St., Suite 800, Philadelphia, PA 19105; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists