New Study Reinforces PCOS-Suicide Connection

by Denis Storey
February 7, 2024 at 7:48 AM UTC

Researchers in Taiwan have unearthed further evidence that women with PCOS are more likely to attempt suicide.

Clinical relevance: Researchers in Taiwan have unearthed further evidence that women with polycystic ovary syndrome (PCOS) are more likely to attempt suicide.

  • Previous research from the UK and Sweden also found associations between PCOS and suicidal ideation, self-harm, and suicide attempts.
  • PCOS, a common endocrine condition, is linked to emotional regulation issues, anxiety, depression, and thoughts of self-harm.
  • Women with PCOS had a significantly higher rate of attempted suicide compared to those without the condition, emphasizing the need for monitoring and support for mental health in PCOS patients.

Researchers in Taiwan have unearthed further evidence that women with polycystic ovary syndrome (PCOS) are more likely to attempt suicide.

This new study, published in the latest Annals of Internal Medicine, backs up earlier research that links PCOS and suicide:

  • A 2022 study out of the United Kingdom found “that the presence of a diagnosis of PCOS is associated with a greater prevalence of recent suicidal ideation, non-suicidal self-injury, and future suicidal intention, as well as greater self-reported scores on measures of rumination and deviant emotion regulation strategy use.” The research linked PCOS and suicidal intentions “through the indirect pathway of increased emotion dysregulation, recent suicidal ideation, and NSSI.”
  • A 2016 Swedish study revealed that women suffering from PCOS were 40% more likely to try suicide than those without the diagnosis. More importantly, this study also showed that siblings shared some of that risk. Sisters of PCOS sufferers endure a 16% higher risk of suicide – even if they don’t share the condition.

Investigating a PCOS-Suicide Connection

PCOS is an endocrine condition that medical professionals have connected to atypical emotional regulation, elevated anxiety and depression levels, thoughts of self-harm, and suicidal ideation. PCOS remains the most prevalent endocrine condition worldwide, affecting anywhere between 8 percent to 13 percent of reproductive-age women. It’s also the leading cause of anovulatory infertility. Typical symptoms include acne, amenorrhea or oligomenorrhea, hirsutism, obesity, hyperandrogenism, and polycystic ovaries.

The cohort study, sampled from between 1997 and 2012, looked at 18,960 women with PCOS. The subject’s age varied from 12 to 64. Each of them had received a PCOS diagnosis. And none of them had a history of suicide before their diagnosis.

The researchers matched the women with 10 control subjects without a PCOS diagnosis, any ovarian disorder, or suicide attempt.

A Stark Difference

While the results weren’t entirely unexpected – given the earlier scientific exploration into this connection – they still painted a stark picture. The researchers found that women with PCOS had a 3 percent attempted suicide rate vs. 0.3 percent rate among the women in the control group.

“These findings emphasize the importance of clinician vigilance in monitoring the mental well-being and suicide risk of patients diagnosed with PCOS,” the study’s lead author, Mu-Hong Chen, MD, PhD, of Taipei Veterans General Hospital in Taiwan, wrote.

A Deeper Dive into the PCOS Data

This increased rate of self-harm remained steady across age groups – except for the younger adult women.

Consequently, the researchers surmised that suicidality could “be related to the persistence of psychological distress, body dissatisfaction, and reproductive concerns in this age group,” piled onto the litany of other problems women at that age face, whether it’s career challenges or relationship issues.

Finally, the researcher discovered that, along with the increased suicide risk, women with PCOS also:

  • Scored higher on the Charlson Comorbidity Index.
  • Attempted suicide at a younger age.
  • Less time between attempts.
  • And an increased number of all-cause clinical visits.

“This study underscores the heightened risk for suicide attempt that persons with PCOS face, even after adjustment for demographics, psychiatric comorbid conditions, physical conditions, and all-cause clinical visits,” the researchers wrote. “This suggests the importance of routine monitoring of mental health and suicide risk in persons diagnosed with PCOS.”

Further Reading:

A Case of Major Depressive Disorder and Symptoms of Polycystic Ovary Syndrome Responding to Escitalopram

Mortality Within 1 Year After Suicide Attempt

Risk-Sensitive Decision-Making and Self-Harm

Clinical and Practical Psychopharmacology

Antipsychotic Medication Continuation vs Taper and Discontinuation in Patients With Schizophrenia and Other Nonaffective Psychotic Disorders

Dr Andrade discusses two studies that examined the outcomes of gradual, individualized antipsychotic dose reduction and discontinuation in patients with psychosis.

Chittaranjan Andrade

Letter to the Editor

Geriatric Depression: What Clinicians Need to Know

The authors discuss what clinicians should be aware of when caring for elderly patients with depression.

Ahmed Naguy and others