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Screen for Anxiety, Mood Disorders in All Women With PCOS: Study


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Screen for Anxiety, Mood Disorders in All Women With PCOS: Study

By Megan Brooks

NEW YORK (Reuters Health) Dec 16 - A new systematic review and meta-analysis shows that women with polycystic ovary syndrome (PCOS) are at higher risk for anxiety and depression.

"Clinicians should screen all women with the diagnosis of PCOS for anxiety disorders," first author Dr. Anuja Dokras of the University of Pennsylvania Medical Center, Philadelphia, told Reuters Health. "The association between anxiety disorders and PCOS is not well known."

Women with PCOS often have low self-esteem, poor body image, and fears about future health problems, including infertility, and perceived lack of effective treatment, all of which may make them anxious, Dr. Dokras and colleagues said in a November 29 online report in Fertility and Sterility.

Yet, only "limited data" exist on the prevalence of anxiety disorders in women with PCOS, the authors say.

From among 613 relevant articles they found nine studies from 2004-2010 that met their strict selection criteria.

Four studies had data on the prevalence of generalized anxiety symptoms in women with clearly defined PCOS and well-selected control women. The prevalence of anxiety was 20% in women with PCOS (42 of 206) vs. 4% in controls (8 of 204). "A variety of validated screening tools were used in the studies reporting the higher prevalence of anxiety symptoms," the authors note.

Women with PCOS had nearly a sevenfold increased risk of generalized anxiety symptoms (pooled odds ratio, 6.88). One study that matched controls on age and body mass index found 13-fold greater odds of anxiety with PCOS.

Most PCOS patients and control subjects in the reviewed studies were overweight or obese.

Of the five studies that reported average anxiety scores, three had significantly higher anxiety scores in women with PCOS compared with control women.

There was little information about other anxiety disorders, such as social phobia, panic attack, and obsessive compulsive disorder. Two of three studies reported a higher prevalence of social phobia in women with PCOS and one of two studies reported a higher prevalence of obsessive compulsive disorder.

Dr. Dokras and colleagues had previously reported that 35% of women with PCOS suffered from depression, a substantially higher rate than the 11% in control women.

Added to that, Dr. Dokras said, the new data suggest that "clinicians should now screen all women with PCOS for both anxiety and mood disorders" using validated screening tools.

Those found to have a mood disorder should be "referred for appropriate evaluation and/or use of psychologic and pharmacologic treatments," the researchers say.

They say more studies are needed to clearly define the prevalence of anxiety disorders in adolescents with PCOS, "given the early age of onset and chronic recurring nature of anxiety disorders."

"Future studies," they advise, "should be aimed at evaluating the association of common PCOS-specific characteristics, such as hyperandrogenism and infertility, with anxiety symptoms and disorders. This will help us to better understand why anxiety is more prevalent in women with PCOS and thereby to individualize therapies."

SOURCE: http://bit.ly/swahV3

Fertil Steril 2011.

Reuters Health Information © 2011

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