Depression in PCOS patients may be due to obesity

A total of 35% of those with polycystic ovary syndrome also had depression in a recent study of 206 women. The study compared a total of 103 PCOS patients with 103 controls. PCOS was diagnosed by the criteria established by the Rotterdam conference in 2003. Anuja Dokras, M.D., Ph.D., and her colleagues used the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire to diagnose major depressive disorder and other depressive syndromes. The Beck Depression Inventory was used to score the severity of depression.

In the PCOS group, 35% (36 women) were classified as depressed, compared with 10.7% (11 women) in the control group. Of these 47 women with depression, 22 were already on antidepressants when they entered the clinic, the study showed. When these 22 women were not considered, the rate of newly diagnosed depression was 21% in the PCOS group and 3% in the control group. Thus, women with PCOS appeared to be 5.11 more likely to have newly diagnosed depression and 4.23 times more likely to have previously diagnosed depression), compared to women who did not have PCOS.

However, the authors were not able to differentiate the effect of obesity from that of PCOS. Women with PCOS had a significantly higher body mass index (BMI) than did women without PCOS. In fact, the average PCOS patient in this study had a BMI in the obese range over 30 (34.9) whereas the non-PCOS women were, on average, not obese (BMI 25.4). In fact, there was a strong correlation amongst the PCOS women between obesity and the chances for being diagnosed with depression. In other words, non-obese PCOS patients were less likely to be diagnosed with depression than obese women.

Also, women with polycystic ovary syndrome PCOS, by definition, have higher levels of androgens such as testosterone in their blood compared to non-PCOS patients. The investigators, however, could not find any correlation between depression and androgen levels.

We can therefore conclude, on the basis of this study, that the depression in PCOS women is due to obesity rather than an effect of the PCOS itself. Obesity has previously been found to be a risk factor for depression in women in other studies. Women with obesity, whether it is due to PCOS or not, should be screened for and treated for depression.