Association Between Menstrual Disorders, Including Polycystic Ovary Syndrome, and Depressive Symptoms in Adolescents

This study evaluates the association between menstrual disorders/disturbances (MD), specifically polyendorcrine metabolic ovarian syndrome (PMOS) and depressive symptoms utilizing the 9-item Patient Health Questionnaire (PHQ-9) in adolescents.

This is a retrospective study utilizing electronic medical records (EMR). The study population consisted of postmenarchal adolescent females aged 12 to 17. A total of 86 patients with PMOS, 384 other patients with MD, and 433 controls were included. Group comparisons were made between patients with MD and controls. Additionally, comparisons were also made between PMOS and controls, as well as PMOS and patients with MD. The PHQ-9 total score was analyzed as a continuous variable with scores ranging from 0 to 27 and as a binomial with score of ≥10 indicating positive screen.

The mean count of PHQ-9 score for the PMOS group was 2.56 times that of the control group after adjusting for age and race. The PMOS group had greater odds of a positive depression screen. Similar trends were seen when looking at patients aged 12-14 and 15 to 17. These findings were similarly found when comparing other MD to controls. There was no significant difference in PHQ-9 scores of patients with PMOS compared to patients with MD.

There appears to be an association of increased depressive symptoms in adolescents with PMOS, and other MD compared to controls. There is no significant difference when comparing PMOS to other MD. The underlying cause of increased PHQ-9 scores is likely multifactorial comprised of physical, mental, and social concerns that menstrual irregularity causes and should be studied further.