Systematic review and meta-analysis of polycystic ovary syndrome and mental health among Black Asian Minority Ethnic populations

Background: Polycystic ovary syndrome (PCOS) is a common, chronic gynaecological condition impacting women of reproductive age. Women with PCOS have hormonal, ovulatory, and metabolic dysfunction resulting in multiple symptoms. The correlation between hormonal disbalance and the impact on women’s mental health (MH) has been researched for decades. However, the prevalence among different ethnicities has not been fully evaluated. Aim: The aim of this study was to explore the prevalence of PCOS among minority ethnic populations. Methods: A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863); moreover, a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis, and sensitivity analysis. These were used to determine the prevalence using variables of PND, anxiety, PTSD, and stress. Results: We included 30 studies reporting on 3,944 PCOS women. The majority of the included studies addressed depression, anxiety, and common mental health symptoms. Studies showed fair to poor methodological quality and included both observational studies and Randomised Clinical Trials (RCTs). Overall, 17% (95% CI: 7% to 29%) of the women with PCOS examined had a clinical diagnosis of major or severe depression; 33% (95% CI: 26% to 40%) had elevated depressive symptoms or a clinical diagnosis of depression; 41% (95% CI: 28% to 54%) reported anxiety symptoms; and 31% (95% CI: 15% to 51%) had a form of common mental health symptomatology or were taking psychiatric medication for anxiety and/or depression. The use of various tools to assess mental health symptoms was among the reasons for the substantial heterogeneity across studies. Conclusions: PCOS is associated with an increased risk of mental health disorders, including depression, anxiety, and other conditions. Approximately 30% of individuals with PCOS are taking psychiatric medication for anxiety and/or depression. While BAME populations account for about 20% of most of the samples studied, stratification by ethnicity was rarely attempted in study design makes it difficult to elucidate the MH impact of PCOS on different communities.