Anuja Dokras1, Elisabeth Stener-Victorin2, Bulent O Yildiz3, Rong Li4, Sasha Ottey5, Duru Shah6, Neill Epperson7, Helena Teede8. 1. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: adokras@obgyn.upenn.edu. 2. Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. 3. Department of Internal Medicine, Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe, Ankara, Turkey. 4. Department of Obstetrics and Gyneocology, Reproductive Medical Center, Peking University Third Hosptal, Bejing, People's Republic of China. 5. PCOS Challenge, Atlanta, Georgia. 6. Gynaecworld, Mumbai, India. 7. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. 8. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University and Monash Health, Clayton, Victoria, Australia.
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 syptoms, HRQOL, and disordered eating.
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 syptoms, HRQOL, and disordered eating.
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