Academic journal article Indian Journal of Psychological Medicine

Prevalence of Psychiatric Disorders in Patients with a Diagnosis of Polycystic Ovary Syndrome in Kashmir

Academic journal article Indian Journal of Psychological Medicine

Prevalence of Psychiatric Disorders in Patients with a Diagnosis of Polycystic Ovary Syndrome in Kashmir

Article excerpt

Byline: Arshad. Hussain, Rajesh. Chandel, Mohd Ashraf. Ganie, Mansoor. Dar, Yasir. Rather, Zaid. Wani, Javid. Shiekh, Majid. Shah

Background: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders and is associated with reproductive, metabolic, and psychological disturbances affecting one in five women of reproductive age group. Objective: To investigate the prevalence of psychiatric disorders among women in ambulatory treatment with a diagnosis of PCOS. Materials and Methods: One hundred and ten patients of PCOS were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of Mini International Neuropsychiatric Interview, English version 5.0.0. Diagnosis of PCOS was confirmed according to the National Institute of Health/National Institute of Child Health and Human Development, 1990 consensus conference criteria. Forty subjects without PCOS who were matched for age and body mass index were taken as a comparison group. Results: About 23% of cases had major depressive disorder as compared to 7.5% of controls, 1.8% had dysthymia, 15.45% had panic disorder compared to 5% of controls, 6.36% had obsessive compulsive disorder compared to 2.5% of controls, 8% cases had suicidality, 2.72% of cases were bipolar affective disorder, and 15.45% had generalized anxiety disorder (GAD). Conclusion: A high prevalence of mental disorders was observed, especially major depression, panic disorder, and GAD in patients with PCOS in our study. The results suggest that screening and appropriate management for psychiatric disorders should be part of the routine evaluation of these patients.

Introduction

Polycystic ovary syndrome (PCOS) is one of the common reproductive endocrine disorders, affecting 5-10% of women of reproductive age. [sup][1] The classic features include menstrual irregularity, biochemical or clinical hyperandrogenism, and ultrasound appearance of polycystic ovaries. [sup][2] The basic physiopathological features in patients with PCOS are obesity and insulin resistance. The resulting state of hyperinsulinemia stimulates the production of ovarian androgen by means of a cytochrome P450c17 enzyme complex, as well as the production of hypophyseal luteinizing hormone, [sup][3],[4] which leads to imbalance in sexual hormones. Endocrine and psychiatric disorders, especially mood disorders, seem to be interconnected and affecting each other. [sup][5],[6] The neuroendocrine systems are crucial not only in reproductive function, but also in mood regulation. [sup][7] Women with PCOS are at increased risk of psychological problems. Some studies in the past have indicated a higher prevalence of psychiatric disorders especially mood disorders in patients with PCOS. [sup][8] There are several reports linking specific PCOS features, such as infertility, [sup][9] hirsutism, [sup][10] and acne [sup][11] to decreased mental well-being. Depression and anxiety symptoms are associated with higher body mass index and waist-to-hip ratio in women with PCOS. [sup][12],[13] Relationships may be further confounded by the use of psychotropic medications, which may induce weight gain.

We undertook this study to estimate the prevalence of psychiatric morbidity in woman with a diagnosis of PCOS presenting to the outpatients department at the Sher-e-Kashmir Institute of Medical Sciences (SKIMS). To our knowledge, this is the first study to look into the psychological issues in the female population with PCOS from Kashmir Valley.

Materials and Methods

Sher-e-Kashmir Institute of Medical Sciences provides tertiary medical care to the whole of Kashmir region along with some adjoining areas of Jammu and Ladakh region, the population of about 6 million. One hundred and ten consecutive consenting patients diagnosed with PCOS were included in the study. The study was approved by the SKIMS Ethical Committee. Diagnosis of PCOS was made by consultant endocrinologist using clinical, biochemical, and ultrasonic parameters. …

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