PURPOSE: Polycystic Ovary Syndrome (PCOS) is one of the most common gynecological endocrine conditions, affecting both the physical and mental health, and the quality of life of women. PCOS was associated with diverse mental disorders but studies in Korean populations were limited. This study aims to investigate the risk of mental disorders in PCOS patients in Korea. PATIENTS AND METHODS: We evaluated the risk of five mental disorders in PCOS patients using health insurance billing data from the National Health Insurance Corporation. We selected 188,973 PCOS patients and 412,022 control individuals. Prevalence, cumulative incidence, and Hazard ratios (HR) were calculated for each mental disorder. RESULTS: We found PCOS patients to have increased prevalence of depressive disorders (Odds ratios (OR) 1.208[1.185-1.232]), bipolar disorders (OR 1.403[1.330-1.479]), and anxiety disorders (OR 1.089[1.064-1.114])
however, PCOS patients also had lower prevalence of schizophrenia (OR 0.686[0.638-0.737]) and sleep disorder (OR 0.911[0.888-0.935]). The PCOS patients exhibited a significantly greater HR in depressive disorder (adjusted HR 1.244[1.148-1.347]), bipolar disorder (adjusted HR 1.502[1.139-1.981]), anxiety disorder (adjusted HR 1.147[1.050-1.252]), and sleep disorder (adjusted HR 1.228[1.112-1.356]). CONCLUSION: Our results suggest that PCOS patients have increased risk of depressive disorders, bipolar disorders, anxiety disorders, and sleep disorders. This study supports international PCOS guidelines that recommend screening for mental health disorders.