Androgen Excess- Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome

Women with polycystic ovary syndrome should be screened for depressive and anxiety symptoms at initial diagnosis given the impact of these disorders on treatment options and quality of life.

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Volume 109, Issue 5, Pages 888–899

Authors:

Anuja Dokras, M.D., Ph.D., Elisabeth Stener-Victorin, Ph.D., Bulent O. Yildiz, M.D., Rong Li, M.D., Sasha Ottey, M.H.A., Duru Shah, M.D., Neill Epperson, M.D., Helena Teede, M.B.B.S., Ph.D.

Abstract:

Objective

To formulate clinical consensus recommendations for screening depression, anxiety, health-related quality of life (HRQoL), and disordered eating symptoms in women with polycystic ovary syndrome (PCOS) and review prevalence based on phenotypes and ethnicity, changes over time, etiology, and impact of treatment.

Design

Systematic reviews and preparation of position statement.

Setting

Not applicable.

Patient(s)

Women with PCOS and controls screened using validated tools.

Intervention(s)

None.

Main Outcome Measure(s)

Depressive symptoms, anxiety symptoms, disordered eating, and HRQoL scores.

Result(s)

Several studies demonstrate that women with PCOS have an increased prevalence of higher depression and anxiety scores and higher odds of moderate and severe depressive and anxiety symptoms compared with controls. Obesity, hyperandrogenism, and fertility have a weak association with these symptoms. HRQoL scores are consistently reduced in PCOS, with infertility and weight concerns having the most significant impact. Some studies suggest an increased prevalence of disordered eating in women with PCOS compared with controls. The few studies that have evaluated the impact of PCOS-related treatments (lifestyle interventions and pharmacotherapy) show no detrimental effect or some improvement in depressive and anxiety symptoms and HRQoL scores.

Conclusion(s)

In women with PCOS, screening for depressive and anxiety symptoms should be offered at the time of diagnosis and screening for disordered eating should be considered. Further research is required across PCOS phenotypes, in longitudinal cohorts and on impact of therapy on depressive and anxiety symptoms, HRQOL, and disordered eating.


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