本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-2240

摘要内容如下：

背景

关于多囊卵巢综合征（PCOS）患者自杀风险的证据有限。

客观

评估多囊卵巢综合征（PCOS）患者的自杀风险，包括精神共病情况和年龄组。

设计

队列研究。

设置

数据来自台湾全国数据库，从1997年到2012年。

病人

一组18960名诊断为多囊卵巢综合征（PCOS）的患者，根据年龄、精神共病状况、城市化水平和收入，以1:10的比例与对照参与者匹配。使用Cox回归模型评估自杀企图。

测量

自杀风险与风险比（HR）。

结果

与对照组相比，PCOS患者的自杀企图风险显著增加8.47倍（HR，8.47[95%CI，7.54-9.51]），在对人口统计学特征、精神共病状况、Charlson共病指数评分和全因临床就诊频率进行校正后。在青少年（HR，5.38[CI，3.93至7.37]）、年轻成人（<40岁；HR，9.15[CI，8.03至10.42]）和老年组（HR，3.75[CI，2.23至6.28]）。排除第一年或前3年观察数据的敏感性分析产生了一致的结果。

局限性

行政索赔数据对多囊卵巢综合征和精神障碍患病率的潜在低估缺乏临床数据，如身体质量指数和抑郁症状；没有评估丙戊酸暴露的混杂效应。

结论

这项研究强调，即使在对人口统计学、精神共病状况、身体状况和全因临床就诊进行调整后，多囊卵巢综合征患者仍面临更高的自杀企图风险。这表明对多囊卵巢综合征患者的心理健康和自杀风险进行常规监测的重要性。

主要资金来源

台北荣民总医院、颜静玲医学基金会、台湾科技部。

英文原文如下：

Abstracts

BACKGROUND  Limited evidence exists about suicide risk in persons with polycystic ovary syndrome (PCOS).

OBJECTIVE  To assess suicide risk in persons with PCOS, accounting for psychiatric comorbid conditions and age group.

DESIGN  Cohort study.

SETTING  Data from the Taiwanese nationwide database from 1997 to 2012.

PATIENTS  A 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.

MEASUREMENTS  Suicide risk with hazard ratios (HRs).

RESULTS  Participants 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.

LIMITATION  Potential 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.

CONCLUSION  This 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 SOURCE  Taipei Veterans General Hospital, Yen Tjing Ling Medical Foundation, and Ministry of Science and Technology of Taiwan.

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