(29) Comparison of Incidence and Severity of Depression in Adolescents with PCOS in an Academic Pediatric Hospital before and during the COVID-19 Pandemic

Background: Adolescents with polycystic ovarian syndrome (PCOS) are thought to be more susceptible to mental stress than their counterparts without PCOS. However, most of the literature describing the correlation between PCOS and depression is focused on adult women.Additionally, the COVID-19 pandemic resulted in a unique set of circumstances for adolescents that affected mental health, and has not yet been studied in adolescents with PCOS. The primary aim of this study is to analyze the differences in the incidence and severity of depression in adolescents with PCOS prior to and during the height of the COVID-19 pandemic from May 2019 to May 2021.

Methods: After obtaining IRB approval from Children’s National Hospital, a retrospective chart review was completed.The electronic medical record system was queried for patients using ICD-10 codes for PCOS, secondary amenorrhea, oligomenorrhea, irregular menses, and hirsutism between May 1st 2019 and May 30th 2021.Charts were reviewed and PCOS diagnosis was confirmed using NIH criteria.The patient health questionnaire-9 (PHQ-9) is a validated instrument for screening, diagnosing, monitoring, and measuring the severity of depression.The Strengths and Difficulties Questionnaires (SDQ) is a brief behavioral screening questionnaire, and validated tool for assessing the mental health of children, young people, and adults.Patients without PCOS, as well as those who did not have PHQ-9 or SDQ screenings performed were excluded.Medical and treatment histories were extracted from the charts and placed into a REDCap survey.

Results: 547 female patients, with well-child visits within the study period were identified.There were 108 patients between 11 and 21 years old with PCOS, that were identified.Depression symptoms in black adolescents (who comprised greater than 70% of the population) increased during the pandemic period.The proportion of black adolescents with mild, moderately severe and severe depressive symptoms were 20%, 0% and 5% pre-pandemic and 26%, 22%, and 22% during the pandemic period, respectively.Interestingly, there was no increase in depressive symptoms during the pandemic in patients with pre-existing major depressive disorder (MDD).

Conclusions: The results of this retrospective analysis indicate that the COVID-19 pandemic had a notable impact on depression among patients with PCOS. Notably, patients in class I and class II obesity weight categories demonstrated reductions in mental health screening scores.To gain a more comprehensive understanding, further research is necessary, including long-term tracking of adolescents and young adults with PCOS and an examination of the impact of PCOS treatments on depression.Additionally, a future study with controls matched for age and BMI is planned.