• Tomor Harnod, I-Ju Tsai, Jen-Hung Wang, Shinn-Zon Lin, and Dr Dah-Ching Ding.
• Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan.
• J Affect Disord. 2020 Aug 1; 273: 532-537.

BackgroundPolycystic ovary syndrome (PCOS) has been associated with developing mental disorders in Western populations, but this association is poorly studied in Asians. Hence, using insurance claims data, this study evaluated the anxiety risk in women with PCOS.MethodsUsing Taiwan's National Health Insurance Research Database, we identified 7026 women aged 15-49 years with newly diagnosed PCOS without anxiety in 1998-2013 as the PCOS cohort. We also randomly selected 28,104 women without PCOS and anxiety as the comparison cohort, which was frequency-matched to cases by age and index year. Determined by incidence and Cox method, the hazard ratio (HR) of anxiety and the 95% confidence interval (CI) for the association with PCOS were estimated after a 16-year follow-up.ResultsThe incidence of anxiety was 19.5% higher in the PCOS cohort than in the comparison cohort (15.3 vs. 12.8 per 1000 person-years), with an adjusted HR of 1.18 (95% CI=1.07-1.30). For women with both PCOS and comorbid depression, it was 32.1 per 1000 person-years, with an adjusted HR of 2.24 (95% CI=1.24-4.06), compared with those without PCOS or depression. Moreover, it was 48.0 per 1000 person-years for women with depression alone (adjusted HR=3.46; 95% CI=2.58-4.64).LimitationsWe used a diagnostic code to identify PCOS cases without reference to pathology records. Miscoding might have occurred in the database.ConclusionsPCOS is associated with an increased risk of developing anxiety independently. Comorbid depression could increase the risk further. Our findings provide vital information for Asian women to cope with anxiety.Copyright © 2020 Elsevier B.V. All rights reserved.

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