QuoteReplyTopic: PCOS Information Posted: 20 February 2007 at 11:57am
Study links PCOS to depression
by Bruce K. Dixon
MONTREAL -- A total of 35% of those with polycystic ovary syndrome also had depression in a case-control study of 206 women.
"We recommend that women with PCOS should be routinely screened and adequately treated for depression," study investigator Elizabeth M. Hollinrake said at the joint annual meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society.
Among women with PCOS, the odds ratio was 5.11 for newly diagnosed depression and 4.23 for depression overall (newly diagnosed and previously diagnosed depression), compared with controls who did not have PCOS, said Ms. Hollinrake, who is a third-year medical student at the University of Iowa, Iowa City.
In an interview, the study's lead author, Anuja Dokras, M.D., Ph.D., noted that the results also show for the first time that depression in PCOS patients is significantly associated with both high body mass index (BMI) and insulin resistance.
"Between 50% and 70% of women who are treated for depression recover completely, so this is an important target population that we should be both screening and treating," added Dr. Dokras of the University of Iowa Hospitals and Clinics in Iowa City.
The study, which earned a first-place award among the General Program Prize Papers that were presented during the meeting, compared a total of 103 PCOS patients with 103 controls.
Women with PCOS diagnosed by the Rotterdam criteria were recruited from a reproductive endocrinology clinic; women without PCOS who attend the gynecology clinic for an annual exam were the controls.
The study investigators used the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire to diagnose major depressive disorder and other depressive syndromes. The Beck Depression Inventory was used to score the severity of depression.
Chi square and t-testing were used to compare differences between women with PCOS and controls, and PCOS women with and without depression.
In the PCOS group, 35% (36 women) were classified as depressed, compared with 10.7% (11 women) in the control group, representing a statistically significant difference. Of these 47 women with depression, 22 were already on antidepressants when they entered the clinic, the study showed.
When these 22 women were not considered, the rate of newly diagnosed depression was 21% in the PCOS group and 3% in the control group.
Women with PCOS had a significantly higher mean BMI than did controls (34.9 vs. 25.4), as did the subset of PCOS women who were depressed, compared with those who screened negative, according to the investigators.
"Although increased BMI among the depressed women is in keeping with the literature, ours is the first study to show this correlation in depressed women with PCOS," Dr. Dokras said.
Among the study participants with PCOS, 11% of those with depression also had diabetes, compared with none of the women without depression; the depressed women also had significantly higher glucose, insulin, and qualitative insulin-sensitivity check index scores.
"Importantly, women with PCOS have higher androgen levels, so one would have expected that if that was the basis, we would find some correlation with depression. On the contrary, these data showed no association with androgens ... only with BMI and insulin resistance," Dr. Dokras said during the interview.
Sources: AARP and Prime Institute/Medi-Span Price-Check PC data
ESHRE: Polycystic Ovary Syndrome Linked to Gestational Development
By Katrina Woznicki, MedPage Today Staff Writer
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of California, San Francisco
June 22, 2005
Also covered by: BBC News
Quote:
MedPage Today Action Points
Inform interested patients that polycystic ovary syndrome may be rooted in gestational development, including reduced fetal and placental growth and excess maternal weight.
Advise women that a strong association was found between a mother's weight during late pregnancy and a daughter's risk for menstrual irregularity, hirsutism, and weight gain.
Review
COPENHAGEN, June 22-High maternal weight and reduced fetal growth may increase a daughter's risk of developing polycystic ovary syndrome (PCOS) later in life, Australian investigators said today.
In a preliminary retrospective study of 414 girls born in the 1970s, the young women's weight, menstrual irregularities, and hirsutism were positively associated with their mothers' weight during pregnancy (p <0.05), the team reported at the European Society for Human Reproduction and Embryology meeting here.
The women were born between 1973 and 1976 at Queen Elizabeth Hospital in Adelaide.
When interviewed by the researchers, 5% were already diagnosed with PCOS, said researchers led by Michael Davies, M.D., a senior research fellow at the Research Centre in Reproductive Health at the University of Adelaide. Twenty-seven percent reported menstrual irregularities, and 19.9% had a Ferriman-Gallway score -- a measure of hirsutism -- of 8+.
Analysis also found a pre-existing PCOS diagnosis was associated with a birth weight on average 196 grams less than that of women without the ovarian syndrome (p = 0.10).
Among other findings, the researchers also reported that women who had ever used the contraceptive pill to manage menstrual irregularities were smaller at birth (p = 0.08), had thinner abdomens at birth (p = 0.08), and smaller head circumferences (p = 0.05).
"Our data suggest that different developmental pathways are implicated in the overlapping symptoms of polycystic ovarian syndrome," Dr. Davies said.
One potential pathway, Dr. Davis proposed, is that excess weight in the mother during late pregnancy may be associated with a greater risk for menstrual irregularity in the daughter. Excess maternal weight, he added, may also be associated with potential obesity and weight-related reproduction problems in the daughters.
A second potential pathway, the researchers suggested, might involve reduced placental and fetal growth, which may contribute to the more severe symptoms of PCOS. "A fetus that has been affected by restricted growth is more likely to have problems with insulin metabolism in later life due to an underlying metabolic problem," Dr. Davies said.
"Our findings," Dr. Davies added, "support the proposition that there is an inter-generational growth path leading to menstrual irregularity, while at the same time, other symptoms may be one of a number of consequences of restricted fetal growth."
These data, though preliminary, support other research that has suggested PCOS may be rooted in gestational development, the team noted.
Primary source: European Society for Human Reproduction and Embryology
Source reference:
European Society for Human Reproduction and Embryology annual meeting in Copenhagen, presented June 22, 2005.
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