PCOS Linked to Risk of Mental Health Disorders, Maternal Development of Autism, ADHD

Aled Rees, MD

Women with polycystic ovary syndrome (PCOS) are at an increased risk of developing mental health conditions and having children with neurodevelopmental disorders, according to a new study.

“When compared with unaffected women, matched for age, body mass index and geographical location, we found that PCOS patients were more likely to be diagnosed with mental health disorders, including depression, anxiety, and bipolar disorder,” study author Aled Rees, MD, of the Neuroscience and Mental Health Research Institute, and the Cardiff University School of Medicine, told MD Magazine. “Children of these mothers were also found to be at greater risk of developing attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).”

Researchers retrospectively assessed the mental health history of selected subjects using data from the Clinical Practice Research Datalink, a longitudinal, anonymized research database collected from 674 primary care practices in the United Kingdom. The study followed these patients from PCOS diagnosis to routine follow-up assessments, for a minimum of 6 months.

Patients with PCOS were matched to 2 control sets (1:1) by age, BMI and primary care practice, with the second control set additionally matched for prior mental health status. Primary outcomes were the incidence of depression, anxiety, and bipolar disorder in women with PCOS; secondary outcomes were the prevalence of ADHD or ASD in their children.

Out of 89,732 patients with PCOS, 16,986 were identified for the study; 16,938 and 16,355 were matched to control sets 1 and 2, respectively. Compared to control set 1, baseline prevalence of depression was 23.1% vs. 19.3%, 11.5% vs. 9.3% for anxiety, and 3.2% vs. 1.5% for bipolar disorder (P <.001) in women with PCOS.

The odds ratios for ASD and ADHD in children were 1.54 (95% CI, 1.12 to 2.11) and 1.64 (95% CI, 1.16 to 2.33) in set 1 and 1.76 (95% CI, 1.27 to 2.46) and 1.34 (95% CI, 0.96 to 1.89) in set 2, respectively.

“Previous studies have suggested a link between PCOS and poor mental health in women, but the studies were small and did not adequately take other factors that can affect mental health into consideration,” said Rees. “The findings in this study suggest that women with PCOS should be screened for mental health disorders to ensure early diagnosis and treatment and ultimately improve their quality of life.”

While the risk of ASD and ADHD is present, the increase is small, with less than 1% of children being diagnosed in both mothers with PCOS and unaffected mothers.

“Prospective mothers with PCOS shouldn’t be too concerned about these findings,” said Rees. “Further research is needed to confirm the neurodevelopment effects of PCOS and to address whether all or some types of patients with PCOS are exposed to mental health risks.”

PCOS impacts an estimated 5% to 10%, of women of childbearing age (ages 15 to 44) in the US, or about 52 million women, according to the Department of Health and Human Services’ Office of Women’s Health.

The study, “Polycystic ovary syndrome is associated with adverse mental health and neurodevelopmental outcomes,” was published in the Journal of Clinical Endocrinology & Metabolism.