Cited by 217Ovarian function and disordersEating Disorders and BehaviorsSexual Differentiation and Disorders

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Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort

Cesta, Carolyn E., Månsson, Mattias, Palm, Camilla, Lichtenstein, Paul, Iliadou, Anastasia N., Landén, Mikael·2016·Psychoneuroendocrinology

DOI 10.1016/j.psyneuen.2016.08.005

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Abstract

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 5-15% of reproductive-aged women and characterized by high levels of circulating androgens. Given that androgens have been implicated in the aetiology of several psychiatric disorders, it was hypothesized that women with PCOS have high risk for psychiatric comorbidity. We aimed to investigate this risk amongst women with PCOS, as well as in their siblings, to elucidate if familial factors underlie any potential associations. Using the Swedish national registers, we identified all women diagnosed with PCOS between 1990 and 2013 (n=24,385), their full-siblings (n=25,921), plus matched individuals (1:10/100) from the general population and their full-siblings. Psychiatric disorder diagnoses were identified including schizophrenia, bipolar disorder, depressive and anxiety disorders, eating disorders, personality and gender identity disorder, autism spectrum disorder (ASD), attention-deficit hyperactivity disorder (ADHD), tics, attempted and completed suicide. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression and adjusted ORs (AOR) were determined by adjustment for comorbid psychiatric disorders. Overall, women with PCOS had an increased odds of having at least one psychiatric disorder (OR=1.56 [95CI%, 1.51-1.61]). Crude ORs showed associations with nearly all psychiatric disorders included in this study. Following adjustment for comorbid psychiatric disorders, women with PCOS were still at a significantly increased risk for bulimia, schizophrenia, bipolar disorder, depressive and anxiety disorders, personality disorders, with the highest AORs for ASD (AOR=1.55 [95%CI, 1.32-1.81]) and tics (AOR=1.65 [95%CI, 1.10-2.47]). Significantly higher AORs were found for ASD in both brothers and sisters of women with PCOS, and for depressive, anxiety, and schizophrenia spectrum disorders in the sisters only. Notably, the crude ORs for attempted suicide were 40% higher in women with PCOS and 16% higher in their unaffected sisters. However, the AORs were greatly attenuated indicating that underlying psychiatric comorbidity is important for this association. Women with PCOS had higher risks for a range of psychiatric disorders not shown before. Elevated risk in their siblings suggests shared familial factors between PCOS and psychiatric disorders. This study is an important first step towards identifying the underlying mechanisms for risk of psychiatric disorders in women with PCOS. Health professionals treating women with PCOS should be aware that these patients - as well as their family members - are important targets for mental health care.

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Authors: Cesta, C. E., Månsson, M., Palm, C., Lichtenstein, P., Iliadou, A. N., & Landén, M.
Affiliations: Karolinska Institutet (SE)
Corresponding author: Cesta, Carolyn E.
ORCID: Cesta, Carolyn E.
Månsson, Mattias
Lichtenstein, Paul
Iliadou, Anastasia N.
Landén, Mikael
Venue: Psychoneuroendocrinology
Publisher: Elsevier BV
Published: 2016-11
Volume: 73
Pages: 196-203
ISSN: 0306-4530 (ISSN-L)
DOI: 10.1016/j.psyneuen.2016.08.005
OpenAlex: W2488412037
Cited by: 217
References: 47
Citations by year: 2026: 13 · 2025: 20 · 2024: 25 · 2023: 31 · 2022: 24 · 2021: 24 · 2020: 27 · 2019: 27 · 2018: 8 · 2017: 15 · 2016: 3
FWCI: 23.48
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Psychoneuroendocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: Swedish Medical Research Council
EU-FP7 Health program
Swedish Foundation for Strategic Research
Strategic Research Program in Epidemiology Young Scholar Awards, Karolinska Institutet
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
Keywords: polycystic ovary syndrome, psychiatric comorbidity, heritability, familial aggregation, autism spectrum disorder, schizophrenia, bipolar disorder, depressive disorders, anxiety disorders, bulimia nervosa, personality disorders, gender dysphoria, tics, suicide attempts, androgens, full siblings, women's mental health, women of reproductive age
MeSH terms: Adolescent, Adult, Mental Disorders, Female, Humans, Polycystic Ovary Syndrome, Registries, Sweden, Cohort Studies, Comorbidity, Siblings, Young Adult

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Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort

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