SUN-166 - Mental Health Prevalence Across A Woman'S Lifetime in Women with Polycystic Ovary Syndrome

Background: Women with polycystic ovary syndrome (PCOS) have a higher risk of mood disorders compared to those without PCOS however, temporal trends in the prevalence of these disorders and changes with age are unknown.

Objective: To assess the change in prevalence of multiple mental health disorders over two decades and to determine the impact of age on prevalence of these disorders among women with PCOS compared to those without PCOS (controls).

Methods: This study used claims data from Optum’s de-identified Clinformatics® Data Mart Database (Optum® CDM) from 2001-2021 to create annual cohorts of women with PCOS (defined using ICD-9/10 codes) and controls, selected via 1:5 age-matching. Mental health outcomes were assessed by ICD 9/10 codes and included anxiety, depression, bipolar disorder, eating disorders, obsessive compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD). For Aim 1, the prevalence of each disorder was compared per year over 2 decades between the PCOS and control groups. For Aim 2, the prevalence of each disorder was assessed in 2021, the most recent year of data, across the following age categories: 18-29, 30-39, 40-49, 50-59, 60+ years.

Results: The prevalence of anxiety disorder increased in both groups from 2001-2021 but was higher in women with PCOS: (5.8% to 28.7% in those with PCOS vs 5.0% to 25.2% in controls). Similar increases in prevalence was seen for all other mental health disorders: depression (PCOS:13.3% to 19.7% vs controls: 10.6% to 15.0%); bipolar: (PCOS: 1.0% to 3.0% vs controls: 0.5% to 1.9%); eating disorders: (PCOS: 0.4% to 1.7% vs controls: 0.3% to 1.0%); OCD: (PCOS: 0.3% to 1.0% vs controls: 0.3% to 0.8%); ADHD: (PCOS: 0.4% to 5.5% vs controls: 0.4% to 4.8%).
In 2021 we observed that the prevalence of all mood disorders in women with PCOS decreased with increasing age: anxiety 30.9% in the 18-29 cohort to 21.1% in the 60+ cohort (p < 0.001), depression (21.5% to 17.8%, p=0.008), bipolar (3.6% to 2.2%, p=0.03), eating disorders (2.4% to 1.0%, p=0.007), OCD (1.7% to 0.2%, p=0.001), and ADHD (7.8% to 2.7%, p< 0.001). In 2021 the prevalence of mood disorders remained higher in women with PCOS vs controls until age 60, but they were no longer higher in the oldest age category (60+) for anxiety (21.1% in PCOS vs 23.3% in controls), bipolar (2.2% vs 2.8%), eating disorders (1.0% vs 0.7%) and OCD (0.2% vs 0.4%), p>0.05 for all. For depression, the prevalence was lower at age 60+ for PCOS vs controls (17.8% vs 20.7%, p=0.046).

Conclusions: Although the overall prevalence of all mental health disorders increased in both groups in our large dataset over the 2-decade study period, it remained higher in women with PCOS. We observed the prevalence of several disorders decreasing in women with PCOS with increasing age and by their 6th decade did not differ significantly compared to controls. These novel data will help comprehensive counseling of women with PCOS.

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