Department of Psychology, City University, London EC1V 0HB, UK.
Hum Reprod. 2011 Sep;26(9):2442-51. doi: 10.1093/humrep/der197. Epub 2011 Jul 1.
Our aim was to assess differences in anxiety and depression between women with and without (controls) polycystic ovary syndrome (PCOS).
We conducted a systematic review and meta-analysis of published literature comparing women with PCOS to control groups on anxiety and depression. Electronic databases were searched up to 17 December 2010. The inverse variance method based, as appropriate, on a random- or fixed-effects model in Review Manager, Version 5 was used to analyse the data.
Twelve comparative studies were included; all studies assessed depression (910 women with PCOS and 1347 controls) and six also assessed anxiety (208 women with PCOS and 169 controls). Analysis revealed higher depression (Z = 17.92, P < 0.00001; Hedges' g = 0.82; 95% CI 0.73-0.92) and anxiety (Z = 5.03, P < 0.00001; Hedges' g = 0.54; 95% CI 0.33-0.75) scores in the participants with, than without, PCOS. Studies controlling for BMI showed a smaller difference between women with PCOS and controls on anxiety and depression scores than studies not controlling for BMI.
Women with PCOS on average tend to experience mildly elevated anxiety and depression, significantly more than women without PCOS. Women with PCOS with lower BMI tended to have slightly lower anxiety and depression scores, suggesting that having a lower BMI reduces anxiety and depression. Future studies might consider (i) controlling for BMI, (ii) stratifying by medication use in order to control for any anti-androgenic effects of medication and (iii) excluding women with polycystic ovaries from control groups.
本研究旨在评估多囊卵巢综合征（PCOS）患者与非 PCOS 患者（对照组）之间焦虑和抑郁的差异。
我们对已发表的比较 PCOS 患者与对照组的焦虑和抑郁的文献进行了系统评价和荟萃分析。电子数据库检索截至 2010 年 12 月 17 日。使用 Review Manager 软件，采用合适的随机或固定效应模型，基于Inverse variance 法进行数据分析。
共纳入 12 项对照研究，其中所有研究均评估了抑郁（910 例 PCOS 患者和 1347 例对照组），6 项研究评估了焦虑（208 例 PCOS 患者和 169 例对照组）。分析结果显示，PCOS 患者的抑郁评分（Z = 17.92，P < 0.00001；Hedges' g = 0.82；95%CI 0.73-0.92）和焦虑评分（Z = 5.03，P < 0.00001；Hedges' g = 0.54；95%CI 0.33-0.75）显著高于非 PCOS 患者。对 BMI 进行校正的研究显示，与未校正 BMI 的研究相比，PCOS 患者与对照组的焦虑和抑郁评分之间的差异较小。
与非 PCOS 患者相比，PCOS 患者的焦虑和抑郁评分平均偏高，差异具有统计学意义。与对照组相比，BMI 较低的 PCOS 患者的焦虑和抑郁评分略低，这提示较低的 BMI 可降低焦虑和抑郁的发生。未来的研究可以考虑（i）对 BMI 进行校正，（ii）根据药物使用情况进行分层，以控制药物的抗雄激素作用，（iii）在对照组中排除多囊卵巢患者。
