The correlation between mental health and number of symptoms endorsed on a review of systems form in polycystic ovary syndrome

Abstract

(1) To determine if a relationship exists between the number of items endorsed on a review of systems (ROS) and depressive symptoms as measured by the Beck Depression Index Fast Screen (BDI-FS) in a cohort of women with polycystic ovary syndrome (PCOS). (2) To further quantify the relationship between various mental health scores to number of symptoms endorsed on the ROS. Cross Sectional Cohort All patients diagnosed with polycystic ovary syndrome by Rotterdam criteria at the multidisciplinary PCOS clinic at the University of California, San Francisco Center for Reproductive Health between August 2005 and April 2018 were offered participation in a cohort study. Patients completed the ROS and Beck Depression Index (BDI-FS) prior to their initial visit. The number of items endorsed on the ROS was correlated to depression scores using Spearman’s correlation coefficient; linear regression models further evaluated the relationship while controlling for age, body mass index (BMI), and education. Additionally, in a smaller cohort with further mental health data, the Generalized Anxiety Disorder (GAD7), PCOS Quality of Life assessment, Eating Disorder Questionnaire, and Patient Health Questionnaire (PHQ-9) scores were correlated to symptoms endorsed on ROS. 425 patients were identified with a diagnosis of PCOS by Rotterdam criteria and had completed ROS data prior to their initial visit. The Spearman’s correlation coefficient between endorsed symptoms on ROS and BDI score was 0.2075 (p=0.001). A multivariate linear regression between ROS and BDI, controlled for age and education, showed an adjusted increased rho of 0.2224 that remained significant. However, BMI was not a significant predictor and decreased the rho to 0.2143. 55 of these 425 patients were accrued within the last 2 years following the transition to online data acquisition with additional mental health parameters assessed (see Table). Positive correlations were noted between ROS symptoms endorsed and PHQ-9, GAD7, and Eating Disorder Exam Questionnaire scores. A negative correlation was noted with PCOS QOL scores.Tabled 1Validated Questionnaires Scores Correlated with Total ROS Score in Smaller Cohort of PCOS PatientsValidated QuestionnaireSample SizeCorrelation Coefficient (rho)p-valuePatientHealth Questionnaire (PHQ-9) Score470.37940.001Generalized Anxiety Disorder (GAD7) Score460.30240.001Eating Disorder Exam Questionnaire Score240.17800.040PCOS Qualityof Life410.19320.004 Open table in a new tab Due to the suggested significant relationship between number of symptoms endorsed on an ROS and BDI-FS scores, the ROS itself may serve as a screen for depression in the PCOS population. A score >8 on ROS should lead to formal screening for depression. ROS may be significantly correlated to additional mental health disorders, though further evidence is required to confirm the relationship.