Anxiety in polycystic ovary syndrome - a meta-analysis

Polycystic ovary syndrome (PCOS) is one of the most common chronic endocrine disorders. One of the serious comorbidity of PCOS are mental disorders including anxiety disorders. The objective of this meta analysis review was to determine the prevalence, the mean level, standardized mean difference and probability of anxiety based on research conducted using the Hospital Anxiety and Depression Scale (HADS-A).

A systematic literature search was conducted using four databases: PubMed, EMBASE, Scopus, ClinicalTrials.gov, and a manual search (Google) for papers written in English published up to October 2023. The meta-analysis was based on 4002 patients obtained from 19 studies that met the inclusion criteria.

The average prevalence of anxiety was found to be 48% (I2=97%; p<0.001), whereas the mean HADS anxiety score of PCOS patients was 9.42 (I2=95%; p<0.001). Standardized difference in mean anxiety scores - SMD=0.274 (95%, confidence interval - 0.12-0.43, I2=18%). The overall probability of anxiety in the group of PCOS patients is about twice higher than in healthy women (RR: 1.91), confidence interval (95% CI [1.52-2.38], I2=51%; p=0.08).

The results obtained indicate that women with PCOS may have a significantly increased risk of anxiety compared to those without PCOS, and confirm the need to implement guidelines according to which a woman with PCOS should undergo mental health screening tests, and conduct long-term observation into routine practice.