March 3, 2009
A current study indicates that polycystic ovarian disease (PCOD), an endocrine disorder, is associated with the risk of mood disorders. The results of the study are published in the January issue of Fertility and Sterility.
Angela Kerchner and colleagues from the Department of Obstetrics and Gynecology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa, conducted a prospective longitudinal study on women with PCOD, who had participated in a previous PCOD study. Out of the 103 women, 60 responded to the current study. Mood disorders, such as major depressive disorder, and other depressive syndromes, like binge eating disorder and anxiety syndromes, were diagnosed using the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire. Questionnaires on the subject’s knowledge of PCOD and treatment satisfaction were filled in.
The study observed 34 subjects (56.6%) with a mood disorder; of these, 11.6% had anxiety syndromes and 23.3% binge eating disorder. With depression prevalence of 40% (24/60), 10 of these subjects were diagnosed with major depressive disorder or associated depressive syndromes and the remaining 14 were on antidepressant medications. During the mean time interval of 22 months (range 12-26 months), 11 new subjects had developed a depressive disorder. Other parameters such as menstrual function, body image (hirsutism, acne, weight) and fertility did not vary significantly between women with and without depression.
A similar study by Hollinrake, et al. (Fertility and Sterility, 2007) at the same center reported an overall increased risk of depressive disorders of 4.23 (p<0.01) in PCOD. The cohort study also revealed that the depressed women were more likely to have a higher body mass index and insulin resistance compared to the non-depressed women (p<0.02).
Polycystic ovarian disease, a common endocrine disorder in women of reproductive age group, has an estimated prevalence of 4-12% in the United States. The disease is characterized by multiple cysts in ovaries, oligomenorrhea or amenorrhea, and hyperandrogenemia. A metabolic syndrome comprising of resistance to insulin, hypertension and dyslipidemia may accompany PCOD, and about half the patients with the disease are overweight or obese. The patients may need assistance for conception through ovulation induction or even in vitro fertilization. There is evidence of increased risk of multiple pregnancy and gestational diabetes with this condition.
A meta-analysis by Boomsma, et al. (Human Reproduction Update, 2006) reported that women with PCOD are at a higher risk of pregnancy-induced hypertension, preeclampsia, Cesarean section, with their newborns at risk of admission to an NICU, perinatal mortality and premature deliveries. Therefore, careful monitoring of these patients during pregnancy and labor is vital to ensure the health of the mother and fetus.
Once larger trials confirm the current findings, the guidelines for screening women with PCOD for depressive disorders can be outlined and further recommendations can be made.
References
1. Kerchner A, Lester W, Stuart SP, Dokras A. Risk of depression and other mental health disorders in women with polycystic ovary syndrome: a longitudinal study. Fertil Steril. 2009 Jan;91(1):207-12. Epub 2008 Feb 4.
2. Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril. 2007 Jun;87(6):1369-76. Epub 2007 Mar 29.
3. Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update. 2006 Nov-Dec;12(6):673-83. Epub 2006 Aug 4.
Written by The MediNEWS Team · Filed Under Neurology, Women’s Health, Gynecology, Psychiatry, Obstetrics, Fertility, Mental Health, Pathology, Medicine, Basic Sciences
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