Association of Polycystic Ovary Syndrome with patient and offspring mental health outcomes: a retrospective, observational study

Date of Approval: 
2016-12-08 00:00:00
Lay Summary: 
Polycystic Ovary Syndrome (PCOS) is the commonest hormonal condition in women of reproductive age, affecting 5-10% of the young female population. The condition is known to impact upon fertility and also is associated with obesity, excessive hair growth and acne. In this study we wish to determine whether females with PCOS have increased rates of depression, anxiety, bipolar disorder, schizophrenia, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) and also whether there is an increased risk of ADHD or autism amongst their children. To do this we wish to select patients from the Clinical Practice Research Datalink (CPRD) with a recorded diagnosis of PCOS and to match them with patients without PCOS by age and general practice. We will then follow these patients to compare the number who subsequently have recorded diagnoses of each of the conditions and also the number of their children who have recorded diagnoses of ADHD and autism spectrum disorders. In so doing, we hope to establish (1) whether women with PCOS should potentially be screened for mental health disorders and (2) whether their children are at increased risk of autism and ADHD.
Technical Summary: 
The aim of the study is to determine if there is an increased risk of mental health outcomes in patients with polycystic Ovary Syndrome (PCOS). Patients will be identified with a diagnosis of PCOS from the Clinical Practice Research Datalink (CPRD) based on either a primary care diagnosis using the Read code classification or an ICD-10 coding from secondary care Hospital Episodes Statistics. Patients will then be matched by age, body mass index and primary care practice to control subjects with no history of PCOS. Subjects will be linked to offspring using the CPRD family number. Primary outcomes will be the incidence of psychiatric morbidity (depressive disorder, anxiety, bi-polar disorder, attention-deficit hyperactivity disorder and autism spectrum disorder identified from either Read code in the CPRD GOLD dataset or ICD-10 code in the HES inpatient dataset. Secondary outcomes will be the incidence of either attention-deficit hyperactivity disorder or autism spectrum disorder in the children of mothers with PCOS. Rates of progression to each primary outcome will be presented and compared using Cox proportional hazard models (CPHM) adjusting for smoking status, Charlson Index, total number of contacts with the general practitioner in the year prior to the index date, and IMD quintile.
Health Outcomes to be Measured: 
Application Number: 

Aled Rees - Chief Investigator - Cardiff University
Aled Rees - Corresponding Applicant - Cardiff University
Christopher Morgan - Collaborator - Pharmatelligence Limited
Sara Jenkins-Jones - Collaborator - Pharmatelligence Limited
Thomas Berni - Collaborator - Pharmatelligence Limited

CPRD Mother-Baby Link;HES Admitted Patient Care;Patient Level Index of Multiple Deprivation