Depressive symptoms in adolescents with and without polycystic ovary syndrome living with obesity: a case-control study

BACKGROUND: Adults with polycystic ovary syndrome (PCOS) and obesity are at risk of depression, but less is known about the relationship between PCOS, obesity, and depression in adolescents. The objective of this study was to establish whether PCOS is associated with symptoms of depression in adolescents living with obesity. METHODS: This was an observational, case-control study of adolescents aged 12-19 years living with obesity (> 95th percentile) with (n = 45) and without (n = 26) PCOS diagnosed according to international criteria. Symptoms of depression were self-assessed using the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Associations between demographic and biochemical variables, PCOS, and symptoms of depression were assessed with the chi-squared test or Student's t-test. RESULTS: The mean (SD) age and BMI Z-score of the study population were 14.8 (2.0) years and 2.19 (0.35), respectively. There were no significant differences in age, BMI Z-score, nor biochemical parameters between patients with and without PCOS. The mean (SD) CES-DC score was significantly higher in patients with PCOS than those without [31.2 (8.9) vs. 13.1 (6.0); p < 0.001]. A diagnosis of PCOS was associated with mild to moderate or major depressive symptoms (p < 0.001), with nearly all (95.6%) patients with PCOS screening positive for the possibility of depression. CONCLUSION: Depressive symptoms are extremely common in adolescents with or without PCOS and matched BMI, suggesting that obesity is not the only mechanism leading to depression. The mechanisms leading to depression in adolescents with PCOS, including relationships between metabolic profiles, PCOS, and depression, require further exploration to personalize therapy in this group of particularly vulnerable individuals.