Women with polycystic ovary syndrome (PCOS) experience higher rates of depression and anxiety. There is limited research relating to perinatal mental health in women with PCOS. Studies suggest PCOS is associated with a higher prevalence of perinatal mental health disorders. Perinatal guidelines currently do not recognise PCOS as a risk factor for perinatal mental health disorders. We aimed to prospectively assess the prevalence of mental health disorders in pregnant women with PCOS.

Consenting pregnant women, with and without PCOS, were invited to participate. Standardised validated questionnaires were carried out including Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS).

Fifty-one with PCOS and 49 without PCOS responded. Pregnant women with PCOS had a higher mean (SD) anxiety score (GAD-7) than those without PCOS (8.2 [6.7] vs. 5.89 [4.7], p = 0.04). Pregnant women with PCOS had higher mean (SD) depression scores than those without PCOS on EPDS (9.1 [6.4] vs. 6.4 [4.5], p = 0.02) but not PHQ-9 score (median (IQR) 4 (3–9) vs. 4 (2–7.5), p = 0.25). Women with PCOS were more likely to experience moderate/severe anxiety (PCOS 34%, control 20%) and moderate/severe depression (PCOS 34%, control 20%) symptoms than women without PCOS. Twenty-nine percent of pregnant women with PCOS had an EPDS score >13 showing significantly higher rates of severe depression (PCOS 29%, control 12%, p = 0.03).

Our findings suggest a higher prevalence of perinatal depression and anxiety in women with PCOS. Our findings may suggest increased need for screening for mental health disorders in women with PCOS.

Perinatal mental health disorders (PMHD) remain often undetected, undiagnosed, and untreated with variable access to perinatal mental health care (PMHC). To guide the design of optimal PMHC (i.e., coproduced with persons with lived experience [PLEs]), this qualitative participatory study explored the experiences, views, and expectations of PLEs, obstetric providers (OP), childcare health providers (CHPs), and mental health providers (MHPs) on PMHC and the care of perinatal depression.

We conducted nine focus groups and 24 individual interviews between December 2020 and May 2022 for a total number of 84 participants (24 PLEs; 30 OPs; 11 CHPs; and 19 MHPs). The PLEs group included women with serious mental illness (SMI) or autistic women who had contact with perinatal health services. We recruited PLEs through social media and a center for psychiatric rehabilitation, and health providers (HPs) through perinatal health networks. We used the inductive six-step process by Braun and Clarke for the thematic analysis.

We found some degree of difference in the identified priorities between PLEs (e.g., personal recovery, person-centered care) and HPs (e.g., common culture, communication between providers, and risk management). Personal recovery in PMHD corresponded to the CHIME framework, that is, connectedness, hope, identity, meaning, and empowerment. Recovery-supporting relations and peer support contributed to personal recovery. Other factors included changes in the socio-cultural conception of the peripartum, challenging stigma (e.g., integrating PMH into standard perinatal healthcare), and service integration.

This analysis generated novel insights into how to improve PMHC for all users including those with SMI or autism.