University of Oulu

Karjula, S., Arffman, R.K., Morin-Papunen, L. et al. A population-based follow-up study shows high psychosis risk in women with PCOS. Arch Womens Ment Health 25, 301–311 (2022).

A population-based follow-up study shows high psychosis risk in women with PCOS

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Author: Karjula, Salla1; Arffman, Riikka K.1; Morin-Papunen, Laure1;
Organizations: 1Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Medical Research Centre Oulu and PEDEGO Research Unit, Oulu, Kajaanintie 50, 90014, Oulu, Finland
2Institute of Reproductive and Developmental Biology, Imperial College, London, W12 ONN, UK
3Department of Epidemiology and Biostatistics, Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College, London, W2 1PG, UK
4Centre for Life Course Epidemiology, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland
5Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, FI-00014, Helsinki, Finland
6Centre for Life Course Health Research, University of Oulu, Box 5000, FI-90014, Oulu, Finland
7Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2022-06-17


Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting up to 18% of women. Besides metabolic and fertility aspects, attention has lately been directed towards the detrimental effect of PCOS on psychological health. The objective of the study was to investigate whether women with PCOS are at higher risk for psychotic disorders. The study population derives from the Northern Finland Birth Cohort 1966 (N = 5889 women). The women with PCOS were identified by two simple questions on oligo-amenorrhea and hirsutism at age 31. Women reporting both symptoms were considered PCOS (N = 124) and asymptomatic women as controls (N = 2145). The diagnosis of psychosis was traced using multiple national registers up to the year 2016. Symptoms of psychopathology were identified using validated questionnaires at age 31. Women with PCOS showed an increased risk for any psychosis by age 50 (HR [95% CI] 2.99, [1.52–5.82]). Also, the risk for psychosis after age 31 was increased (HR 2.68 [1.21–5.92]). The results did not change after adjusting for parental history of psychosis, nor were they explained by body mass index or hyperandrogenism at adulthood. The scales of psychopathology differed between women with PCOS and non-PCOS controls showing more psychopathologies among the affected women. PCOS cases were found to be at a three-fold risk for psychosis, and they had increased psychopathological symptoms. PCOS should be taken into consideration when treating women in psychiatric care. More studies are required to further assess the relationship between PCOS and psychotic diseases.

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Series: Archives of women's mental health
ISSN: 1434-1816
ISSN-E: 1435-1102
ISSN-L: 1434-1816
Volume: 25
Issue: 2
Pages: 301 - 311
DOI: 10.1007/s00737-021-01195-4
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3124 Neurology and psychiatry
Funding: Open Access funding provided by University of Oulu including Oulu University Hospital. The study was funded by the Finnish Medical Foundation, the Northern Ostrobothnia Regional Fund, the University of Oulu Scholarship Foundation, Emil Aaltonen Foundation, the Academy of Finland (104781, 120315, 129269, 268336, 321763, 315921, 1114194, 24300796), the Sigrid Juselius Foundation, Biocenter Oulu, University Hospital Oulu and University of Oulu (75617), Medical Research Center Oulu, National Institute for Health Research (UK), Genesis Research Trust (UK), and Medical Research Council, UK (G0500539, G0600705, G1002319, G0802782).
Academy of Finland Grant Number: 120315
Detailed Information: 120315 (Academy of Finland Funding decision)
129269 (Academy of Finland Funding decision)
268336 (Academy of Finland Funding decision)
321763 (Academy of Finland Funding decision)
315921 (Academy of Finland Funding decision)
114194 (Academy of Finland Funding decision)
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