Prevalence of depression among women with polycystic ovary syndrome in mainland China: a systematic review and meta-analysis.

OBJECTIVE

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.

METHOD

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.

RESULTS

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.

CONCLUSIONS

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.