Long-term consequences of polycystic ovary syndrome on mental health and health-related quality of life

Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. It affects 9–18% of the female population, but often remains undiagnosed. In addition to the common somatic comorbidities of the syndrome, including decreased fertility and hormonal and metabo...

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Bibliographic Details
Main Author: Karjula, S. (Salla)
Other Authors: Piltonen, T. (Terhi)
Format: Doctoral or Postdoctoral Thesis
Language:English
Published: Oulun yliopisto 2021
Subjects:
Online Access:http://urn.fi/urn:isbn:9789526228495
Description
Summary:Abstract Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. It affects 9–18% of the female population, but often remains undiagnosed. In addition to the common somatic comorbidities of the syndrome, including decreased fertility and hormonal and metabolic issues, there is emerging evidence showing higher risk for psychological distress, especially depression and anxiety, in PCOS. Furthermore, the latest studies indicate an increased prevalence of more severe psychiatric diseases, e.g., schizophrenia, in females with PCOS. Thus, PCOS exerts a severe health burden which decreases the health-related quality of life (HRQoL). Despite increasing interest and research, it is still unclear how the psychological and psychiatric health and HRQoL of women with PCOS are affected through aging up to menopause, as most studies have been conducted on reproductive-aged women. The main aim of this work was to assess the risk for psychological distress and decreased HRQoL in PCOS during two different time points, at age 31 and 46, using data from the prospective longitudinal Northern Finland Birth Cohort 1966 (NFBC66). Additionally, the long-term psychosis risk in women with PCOS was assessed by linking the NFBC66 data with the national registers. The results showed a higher prevalence of anxiety and/or depression symptoms in women with PCOS at both ages. The lifetime risk for depression was nearly 2-fold higher up to age 46. PCOS was also associated with a 3-fold higher risk for psychosis until age 50, even after adjusting for parental history of psychosis, which is the most common risk factor. The affected women showed a lower HRQoL up to age 46, in addition to a decreased health status and life satisfaction. The analyses indicated that the findings could not be explained by overweight, obesity, hyperandrogenism, or infertility. Overall, the findings suggest that PCOS is an independent risk factor for psychological distress up to a late reproductive age. The study showed that ...