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Review
. 2023 Oct 10;12(20):6446.
doi: 10.3390/jcm12206446.

Depression in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Paweł Dybciak  1 , Dorota Raczkiewicz  2 , Ewa Humeniuk  3 , Tomasz Powrózek  4 , Mariusz Gujski  5 , Teresa Małecka-Massalska  4 , Artur Wdowiak  6 , Iwona Bojar  7
Affiliations
Review

Depression in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Paweł Dybciak et al. J Clin Med. .

Abstract

Polycystic ovary syndrome (PCOS) is an endocrine disorder with a broad spectrum of clinical symptoms. Some of the serious complications of PCOS are mental disorders including depression. Therefore, the aim of the meta-analysis was to determine the prevalence, mean level, standardized mean difference and probability of depression based on the research conducted with the Hospital Anxiety and Depression Scale (HADS). A systematic literature search was performed using the following databases: PubMed, EMBASE, Scopus, ClinicalTrials.gov and Google for research published until January 2023. The meta-analysis was conducted on a group of 4002 patients obtained from 19 studies, which met the inclusion criteria (adult pre-menopausal women diagnosed with PCOS, papers on the prevalence of depression or the HADS scoring). According to the research performed, the mean prevalence of depression was 31% (I2 = 93%; p < 0.001), whereas the mean HADS depression score in patients with PCOS was 6.31 (I2 = 93%; p < 0.001). The standardized difference of mean depression scores was SMD = 0.421 (95% confidence interval = 0.17-0.68, I2 = 67%). The overall probability of depression in PCOS patients was more than 2.5-fold higher than in healthy women ((RR: 2.58), confidence interval [1.38-4.85]; I2 = 90%, p < 0.001). The research results imply an increased risk of depressive symptoms in women with PCOS.

Keywords: depression; mental health; polycystic ovary syndrome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scheme of research methodology for the systematic review based on the PRISMA guidelines.
Figure 2
Figure 2
Risk of bias of studies included in the meta-analysis. (a) Risk of bias summary: review of the authors’ own judgments about each risk of bias item for each included study. (b) Risk of bias graph: review the authors’ own judgments about each risk of bias item presented as percentages across all included studies. Figure generated by Cochrane Risk of Bias 2 (RoB 2) tool, [6,7,15,16,17,19,20,33,34,35,37,42,43,44,45,46,47,48,49].
Figure 3
Figure 3
Forest plot of the meta-analyzed prevalence of depression in PCOS patients (figure generated by MetaXL (EpiGear, Sunrise Beach, Australia) software version 5.3), [7,15,16,17,19,20,34,35,40,42,44,45,46].
Figure 4
Figure 4
Forest plot of the meta-analyzed mean depression scores in PCOS patients (figure generated by MetaXL (EpiGear, Sunrise Beach, Australia) software version 5.3) [6,7,15,17,33,37,43,44,45,46,47,48,49].
Figure 5
Figure 5
Meta-analysis using a random effects model for the SMD of the HADS-D score between control and PCOS individuals (a); funnel plot of SMD for depression meta-analysis (b); Doi plot and LFK index for the detection of publication bias (c). Figures generated by MetaXL (EpiGear, Sunrise Beach, Australia) software version 5.3 [6,7,37,45,47,49].
Figure 5
Figure 5
Meta-analysis using a random effects model for the SMD of the HADS-D score between control and PCOS individuals (a); funnel plot of SMD for depression meta-analysis (b); Doi plot and LFK index for the detection of publication bias (c). Figures generated by MetaXL (EpiGear, Sunrise Beach, Australia) software version 5.3 [6,7,37,45,47,49].
Figure 6
Figure 6
Relative risk (RR) meta-analysis plot (random effects model): probability of the incidence of depression in PCOS patients (a); funnel plot of RR for depression meta-analysis (b); Doi plot and LFK index for the detection of publication bias (c). Figures generated by MetaXL (EpiGear, Sunrise Beach, Australia) software version 5.3 [7,16,20,35,45].
See this image and copyright information in PMC

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