• Tien-Wei Hsu, Yu-Chen Kao, Shih-Jen Tsai, Ya-Mei Bai, Tung-Ping Su, Tzeng-Ji Chen, Chih-Sung Liang, and Mu-Hong Chen.
• Department of Psychiatry, E-DA Dachang Hospital, and Department of Psychiatry, E-DA Hospital, Kaohsiung, Taiwan (T.-W.H.).
• Ann. Intern. Med. 2024 Mar 1; 177 (3): 335342335-342.

BackgroundLimited evidence exists about suicide risk in persons with polycystic ovary syndrome (PCOS).ObjectiveTo assess suicide risk in persons with PCOS, accounting for psychiatric comorbid conditions and age group.DesignCohort study.SettingData from the Taiwanese nationwide database from 1997 to 2012.PatientsA cohort of 18 960 patients diagnosed with PCOS, each matched with control participants in a 1:10 ratio on the basis of age, psychiatric comorbid conditions, urbanization level, and income. Suicide attempts were evaluated using Cox regression models.MeasurementsSuicide risk with hazard ratios (HRs).ResultsParticipants with PCOS had a notable 8.47-fold increase in risk for suicide attempt compared with the control group (HR, 8.47 [95% CI, 7.54 to 9.51]), after adjustment for demographic characteristics, psychiatric comorbid conditions, Charlson Comorbidity Index scores, and frequency of all-cause clinical visits. The elevated risk was evident across the adolescent (HR, 5.38 [CI, 3.93 to 7.37]), young adult (<40 years; HR, 9.15 [CI, 8.03 to 10.42]), and older adult (HR, 3.75 [CI, 2.23 to 6.28]) groups. Sensitivity analyses involving the exclusion of data from the first year or the first 3 years of observation yielded consistent results.LimitationPotential underestimation of PCOS and mental disorder prevalence due to use of administrative claims data; lack of clinical data, such as body mass index and depressive symptoms; and no assessment of a confounding effect of valproic acid exposure.ConclusionThis 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. This suggests the importance of routine monitoring of mental health and suicide risk in persons diagnosed with PCOS.Primary Funding SourceTaipei Veterans General Hospital, Yen Tjing Ling Medical Foundation, and Ministry of Science and Technology of Taiwan.

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