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Study on PCOS and suicide risk reveals correlation


Study on PCOS and suicide risk reveals correlation | Image credit: © Paolese – © Paolese – stock.adobe.com.

The risk of suicide attempts increases among people with polycystic ovary syndrome (PCOS), according to a recent study published in Annals of Internal Medicine.1

Food for take away

  1. People diagnosed with polycystic ovary syndrome (PCOS) face a significantly increased risk of suicide attempts compared to the general population, as indicated by a study using data from a Taiwanese national database.
  2. The increased risk of suicide attempts associated with PCOS varies across age groups, with adolescents, young adults, and older adults having different risk rates.
  3. Given the increased risk of suicide, it is essential to prioritize mental health management for people with PCOS. This includes regular screening, appropriate interventions and support services to address psychological well-being.
  4. The development and use of disease-specific instruments, such as the Polycystic Ovary Syndrome Questionnaire (PCOSQ), are essential to assess health-related quality of life (HRQoL) in patients with PCOS. The PCOSQ-50, a widely used version, encompasses multiple domains reflecting the multifaceted impact of PCOS on HRQoL.
  5. HRQOL assessment tools for patients with PCOS need to be refined, as indicated by findings suggesting potential improvements in factor models. Separating domains such as obesity and menstrual disorders could improve the accuracy and depth of assessment, leading to better understanding and treatment of PCOS.

Data for the study were obtained from Taiwan’s national database and included 18,960 patients diagnosed with PCOS between 1997 and 2002. These patients were matched 1:10 with controls based on comorbid psychiatric conditions, age, income and level of urbanization.

Cox regression models were used to analyze suicide attempts, and hazard ratios (HRs) were used to measure suicide risk. The HR for suicide attempts was 8.47 among participants with PCOS, indicating an 8.47-fold increased risk. Among adolescents, young adults, and older adults, the HRs were 5.38, 9.15, and 3.75, respectively.

The researchers concluded that mental health and suicide risk should be monitored in patients with PCOS. To improve health-related quality of life (HRQoL) in affected patients, a condition-specific instrument is necessary to monitor HRQoL.2

The first PCOS-specific HRQoL instrument was the Polycystic Ovary Syndrome Questionnaire (PCOSQ), a 26-item tool that assesses HRQoL on a 7-point Likert scale, with higher scores indicating better function. . A more commonly applied version of this instrument is the PCOSQ-50, which includes 50 items in 6 domains: psychological, fertility, sexual function, obesity/menstrual disorders, hirsutism, and coping.

HRQOL in women with PCOS aged 18 to 42 years was evaluated in a cross-sectional study. PCOS-specific HRQoL was determined using a cross-sectional, Internet-based survey using electronic research data capture.

Race, age, educational level, geographic location, number of children and comorbid conditions, and marital, employment, and insurance status were determined during a demographic questionnaire. PCOS diagnosis was self-reported and had strong agreement with electronic medical records.

The PCOSQ-50 measures these items on a 5-point Likert scale, with the total score calculated as the sum of all responses divided by the number of items answered. Improvement in HRQoL is determined by the decrease in scores.

935 participants were included in the final analysis, aged 31.0 ± 5.8 years. Of the participants, 72% were white, 56% had a college degree, 69% were married, and 65% worked full time. The presence of one or more chronic conditions, such as type 2 diabetes, hypertension, hypothyroidism, and arthritis, was reported along with PCOS in 74% of participants.

The lowest mean standard deviation (SD) among the subscales was 1.36 on the fertility item “In the past 4 weeks, how often have you experienced fear of divorce or separation?” The highest SD was 3.27 for the item obesity/menstrual disorders “In the last 4 weeks, how often have you felt worried about being overweight?”

An acceptable Kaiser-Meyer-Olkin measure of sampling adequacy for the model was reported as 0.93. While this indicated that the model was adequate, confirmatory factor analysis found improved results from a 7-factor model compared to the 6-factor model currently used.

Currently, obesity and menstrual conditions are included in a single domain. Separating these factors may improve accuracy and allow further evaluation of PCOS in women.

Reference

  1. Hsu T, Kao Y, Tsai S, et al. Suicide attempts after a diagnosis of polycystic ovary syndrome. Annals of Internal Medicine. 2024.doi:10.7326/M23-2240
  2. Wright PJ, Tavakoli AS, Dawson RM. Exploratory and confirmatory factor analysis of the polycystic ovary syndrome health-related quality of life questionnaire (PCOSQ-50). Quality of life health outcomes. 2024;22(1):15. doi:10.1186/s12955-024-02228-z



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