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Mental Health and Psychosocial Care Mood and the Cycle

Systematic review and meta-analysis of polycystic ovary syndrome and mental health among Black Asian Minority Ethnic populations

Delanerolle G, Ayis S, Barzilova V, Phiri P, Jagadeesan P, Zeng Y, Ranaweera S, Shetty A, Haque N, Kar D, Majumder K, Rathod S, Raymont V, Shi JQ, Hapangama DK

Published February 6, 2025 Academia Mental Health and Well-Being
DOI 10.20935/mhealthwellb7404

RRM Academy Synopsis

Depression and anxiety are common among women with PMOS / PCOS

Researchers combined 30 studies of 3,944 women with polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS). Depression and anxiety were common. About 3 out of 10 had depression symptoms or a diagnosis. About 4 out of 10 had anxiety symptoms.

Key Findings

  • The review included 30 studies reporting on 3,944 women with polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS). Study quality was fair to poor.
  • Major or severe depression had been diagnosed clinically in 17% (95% CI: 7% to 29%) of women, with rates across studies ranging from 0% to 67%.
  • Raised depressive symptoms, including clinically diagnosed depression, were found in 33% (95% CI: 26% to 40%), pooled from 24 studies including 3157 women.
  • Anxiety symptoms were reported by 41% (95% CI: 28% to 54%). Common mental health symptoms, or psychiatric medication for anxiety or depression, were present in 31% (95% CI: 15% to 51%).
  • In the narrative synthesis, certain populations, such as Indian and Middle Eastern, had higher rates of depression than Caucasian counterparts. Race and ethnicity could not be pooled in the meta-analysis.

Interpretation

This systematic review and meta-analysis combined 30 studies of women with polyendocrine metabolic ovarian syndrome (PMOS), also called polycystic ovary syndrome (PCOS). The goal was to see how common depression and anxiety are in this group. The authors note that few studies reported results by race or ethnicity. Because of this, the pooled numbers describe women with the condition as a whole. The findings support larger studies on mental health in PMOS/PCOS, including studies that compare results across ethnic groups.

RRM Context

The authors describe hormone, ovulation and metabolic problems that cause these symptoms. They note that some clinicians focus on one symptom, like infertility, instead of the whole person. Restorative reproductive medicine takes that wider view. It treats the underlying dysfunction and cares for the whole person.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Polycystic ovary syndrome (PCOS) is a common, chronic gynaecological condition impacting women of reproductive age. Women with PCOS have hormonal, ovulatory, and metabolic dysfunction resulting in multiple symptoms. The correlation between hormonal disbalance and the impact on women’s mental health (MH) has been researched for decades. However, the prevalence among different ethnicities has not been fully evaluated.

Aim

The aim of this study was to explore the prevalence of PCOS among minority ethnic populations.

Methods

A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863); moreover, a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis, and sensitivity analysis. These were used to determine the prevalence using variables of PND, anxiety, PTSD, and stress.

Results

We included 30 studies reporting on 3,944 PCOS women. The majority of the included studies addressed depression, anxiety, and common mental health symptoms. Studies showed fair to poor methodological quality and included both observational studies and Randomised Clinical Trials (RCTs). Overall, 17% (95% CI: 7% to 29%) of the women with PCOS examined had a clinical diagnosis of major or severe depression; 33% (95% CI: 26% to 40%) had elevated depressive symptoms or a clinical diagnosis of depression; 41% (95% CI: 28% to 54%) reported anxiety symptoms; and 31% (95% CI: 15% to 51%) had a form of common mental health symptomatology or were taking psychiatric medication for anxiety and/or depression. The use of various tools to assess mental health symptoms was among the reasons for the substantial heterogeneity across studies.

Conclusions

PCOS is associated with an increased risk of mental health disorders, including depression, anxiety, and other conditions. Approximately 30% of individuals with PCOS are taking psychiatric medication for anxiety and/or depression. While BAME populations account for about 20% of most of the samples studied, stratification by ethnicity was rarely attempted in study design makes it difficult to elucidate the MH impact of PCOS on different communities.

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By this author

Related research

Mental Health and Psychosocial Care › Mood and the Cycle › Hormonal Medication and Mood
Gayathri Delanerolle, Salma Ayis, Vanya Barzilova, Peter Phiri, Priyanka Jagadeesan, Yutain Zeng, Sandali Ranaweera, Ashish Shetty, Nyla Haque, Debasish Kar, Kingshuk Majumder, Shanaya Rathod, Vanessa Raymont, Jian Qing Shi, Dharani K. Hapangama
G Delanerolle, S Ayis, V Barzilova, Pete Phiri, P Phiri, P Jagadeesan, Y Zeng, S Ranaweera, A Shetty, N Haque, D Kar, K Majumder, S Rathod, V Raymont, J Shi, D Hapangama
DOI 10.20935/mhealthwellb7404 10.20935/mhealthwellb7404 Delanerolle et al. 2025, Delanerolle 2025

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