Hong Zhenzhen, Wu Peiya, Zhuang Huihong, Chen Liying, Hong Shanshan, Qin Jiawei
Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China.
Department of Reproductive Medicine, Quan Zhou Women's and Children's Hospital, Quanzhou, China.
BMC Psychiatry. 2024 Dec 18;24(1):920. doi: 10.1186/s12888-024-06378-8.
Polycystic ovary syndrome (PCOS), a prevalent endocrine disorder among women, is frequently comorbid with depression. This systematic review and meta-analysis aimed to estimate the prevalence of depression among women with PCOS in mainland China.
A comprehensive literature search was conducted in PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and Chinese databases (CNKI, WanFang, and VIP) up to August 2024. Random-effects models were applied to estimate the pooled prevalence of depression with 95% confidence intervals. The methodological quality assessment was assessed using the risk of bias tool. The primary outcome was the pooled prevalence of depression in women with PCOS.
Thirty-nine studies encompassing 9796 participants were analyzed. The pooled prevalence of depression was 37% (95% CI, 29%-44%), with substantial heterogeneity (I = 96%, p < 0.001). In subgroup analysis, the prevalence of depression among women with PCOS in West, Central, East, and Northeast China was 37%, 37%, 38%, and 25%, respectively. The prevalence of depression among women with PCOS surveyed before and after 2015 was 40% and 35%, respectively. The prevalence of depression among women with PCOS aged < 26 and > / = 26 years were 42% and 33%, respectively. The prevalence of depression among women with PCOS that participants' BMI < 24 and > / = 24 kg/m were 38% and 34%, respectively. The prevalence of depression among women with PCOS that used Self-rating Depression Scale (SDS), Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS) were 40%, 34%, 31%, and 24%, respectively. Sensitivity analysis and meta-regression confirmed the stability of the findings. Evidence of publication bias was detected.
The high prevalence of depression among women with PCOS in China underscores the need for integrated screening and management. The results of this meta-analysis show high heterogeneity and indicate publication bias, which reduces the generalizability of the findings. Future research should address heterogeneity and enhance the applicability of results.
多囊卵巢综合征（PCOS）是女性中一种常见的内分泌紊乱疾病，常与抑郁症共病。本系统评价和荟萃分析旨在估计中国大陆PCOS女性中抑郁症的患病率。
截至2024年8月，在PubMed、EMBASE、Cochrane对照试验中心注册库和中文数据库（中国知网、万方和维普）中进行了全面的文献检索。应用随机效应模型估计抑郁症的合并患病率及95%置信区间。使用偏倚风险工具评估方法学质量。主要结局是PCOS女性中抑郁症的合并患病率。
分析了39项研究，共9796名参与者。抑郁症的合并患病率为37%（95%CI，29%-44%），存在显著异质性（I=96%，p<0.001）。亚组分析中，中国西部、中部、东部和东北部PCOS女性中抑郁症的患病率分别为37%、37%、38%和25%。2015年之前和之后调查的PCOS女性中抑郁症的患病率分别为40%和35%。年龄<26岁和≥26岁的PCOS女性中抑郁症的患病率分别为42%和33%。参与者BMI<24和≥24kg/m²的PCOS女性中抑郁症的患病率分别为38%和34%。使用自评抑郁量表（SDS）、患者健康问卷-9（PHQ-9）、贝克抑郁量表（BDI）和医院焦虑抑郁量表（HADS）的PCOS女性中抑郁症的患病率分别为40%、34%、31%和24%。敏感性分析和Meta回归证实了研究结果的稳定性。检测到发表偏倚的证据。
中国PCOS女性中抑郁症的高患病率凸显了综合筛查和管理的必要性。本荟萃分析结果显示高度异质性并存在发表偏倚，这降低了研究结果的普遍性。未来的研究应解决异质性问题并提高结果的适用性。
