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 (I² = 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/m² 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.