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Fertil Steril. 2019 Jan;111(1):147-156. doi: 10.1016/j.fertnstert.2018.10.004. Epub 2018 Nov 17.

Clinical course of depression symptoms and predictors of enduring depression risk in women with polycystic ovary syndrome: Results of a longitudinal study.

Author information

1
Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, California. Electronic address: eleni.greenwood@ucsf.edu.
2
Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, California.
3
Department of Dermatology, University of California San Francisco, San Francisco, California.

Abstract

OBJECTIVE:

To [1] characterize depression symptoms over time and [2] test the hypothesis that adverse metabolic parameters would associate with risk of enduring depression risk in women with polycystic ovary syndrome (PCOS).

DESIGN:

Prospective cohort study.

SETTING:

University center.

PATIENT(S):

One hundred sixty-three women with PCOS.

INTERVENTION(S):

The Beck Depression Inventory Fast Screen (BDI-FS) was self-administered at baseline and follow-up to identify depression risk, using a cutoff score >4.

MAIN OUTCOME MEASURE(S):

BDI-FS scores.

RESULT(S):

Median baseline age was 29.0 years, and median follow-up interval was 5.5 years. Fifty-nine of 163 women had positive depression screens at baseline (36%); 52 women (32%) screened positive at follow-up. Median change in BDI-II score was 0 (interquartile range, -2, 1) over the study period. Of the 59 women at risk for depression at baseline, 22 screened negative at follow-up (37%), while 37 women remained at risk (63%). Considering these 59 women with positive depression screens at baseline, higher body mass index (BMI) was associated with increased odds of enduring depression risk at follow-up (adjusted odds ratio = 1.09; 95% confidence interval, 1.00, 1.18), in a multivariate logistic regression model. Compared with women with normal body weight at baseline, obese women (BMI >30 kg/m2) had five-fold increased odds of enduring depression risk at follow-up (adjusted odds ratio = 5.07; 95% confidence interval, 1.07, 24.0).

CONCLUSION(S):

The prevalence of depression was relatively stable over time in a cohort of women with PCOS. Elevated BMI is a hallmark of enduring depression risk. These results may assist providers in developing targeted intervention strategies to reduce the prevalence of long-term depressive symptoms in women with PCOS.

KEYWORDS:

Polycystic ovary syndrome (PCOS); depression; obesity

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