Feb. 6, 2024 -- Women with polycystic ovary syndrome (PCOS) may be as much as eight times more likely to attempt suicide as are those without the disorder, according to a new study published Monday in the Annals of Internal Medicine.
The results point to the importance of mental health screening for all patients who may have PCOS, the researchers concluded.
"If we can know such conditions earlier in our clinical practice, we may reduce the subsequence risk and bad consequences," said Mu-Hong Chen, MD, PhD, an attending psychiatrist at the Department of Psychiatry at Taipei Veterans General Hospital in Taiwan, a co-author of the study.
PCOS affects as many as 15% of reproductive-age women in the United States, or about 6 million people. The condition is associated with an increased risk for metabolic disorders, like diabetes and metabolic syndrome, and cardiovascular problems, like hypertension and stroke. The disorder is associated with infertility, weight gain, hirsutism, and skin changes. Evidence also shows that these changes can lead to poorer self-image and mental health conditions like depression and anxiety.
Chen and his co-authors compared the records of nearly 19,000 women between the ages of 12 and 64 years who had a PCOS diagnosis with a matched control group of 189,600 women and girls without PCOS using data from 1997 to 2012 in the Taiwan National Health Insurance Research Database. Cohorts were matched by age, income, urbanization level, and mental health conditions.
The researchers found that the women diagnosed with PCOS were at an 8.47 times higher risk for suicide attempt over the 16-year follow-up period than were women without the condition. Older women with PCOS had slightly lower risk compared with younger women, but the risk was higher compared with older women without PCOS. Studies in other countries have shown similar results.
The number of women with PCOS in the study was likely underreported, and those who were included likely had more serious cases, according to Ricardo Azziz, MD, MPH, professor in the Department of Obstetrics & Gynecology and the Department of Medicine at the University of Alabama at Birmingham.
The findings, "speak to the fact that women with PCOS do have a greater incidence of mental health disorders and do require clinicians and patients themselves and their families to be aware of these risks," said Azziz, who is also former CEO of the American Society for Reproductive Medicine.
Clinicians should ask their patients with PCOS about suicide risk and mental health, Azziz said.
"It's not infrequent that those of us in clinical practice see patients who are significantly depressed, and we need to ask the right questions," he said.
Though he was only aware of a few patients with PCOS who have attempted suicide, he said clinicians should be prepared to refer these patients to another professional who can address mental health concerns if they express any signs of distress.
"Simply asking and inviting patients to speak about this will allow physicians to identify patients who may need to be referred," Azziz said.
