Abstract
Depression and Anxiety Risk in Acne Patients with PCOS Treated With Oral Contraceptives and/or Spironolactone: A 5-Year Retrospective Cohort Study using the TrinetX database
Journal of the American Academy of Dermatology, v 95(1), AB141
Jul 2026
Abstract
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder that affects premenopausal women and is associated with an increased risk of depression and anxiety. Individuals with PCOS are frequently treated with spironolactone or oral contraceptive pills (OCPs); however, limited studies have examined the psychiatric effects of these treatments. This multicenter retrospective study utilized the TriNetX database to evaluate female patients with both acne and PCOS across four defined cohorts: (1) spironolactone and OCPs, (2) neither medication, (3) spironolactone only, and (4) OCPs only. Cohorts required greater than 5 prescription refills for spironolactone and/or OCPs. All cohorts excluded prior isotretinoin use. Cohorts were 1:1 propensity score matched for age, sex, and ethnicity. Relative risks (RR) with 95% confidence intervals were calculated at five- years after exposure, with statistical significance was set at p<0.0001. PCOS itself shows an increased 5-year risk of depression (RR: 1.347; CI: 1.222-1.484; p<0.0001) and anxiety (RR: 1.535; CI: 1.535-2.006; p<0.0001). Among treatment groups, OCPs showed the greatest association with psychiatric outcomes, either alone (depression: RR: 2.119; CI: 1.927-2.33; p<0.000; anxiety: RR: 1.918; CI: 1.778-2.069; p<0.0001) or in combination with spironolactone (RR: 2.061; CI: 1.739-2.443; p<0.0001; anxiety: RR:1.754; CI: 1.535-2.006; p<0.0001). These findings suggest that psychiatric outcomes in PCOS patients are potentially amplified by commonly prescribed treatments. Future prospective studies are needed to determine whether these risks reflect the underlying PCOS severity, medication effects, or both.
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Details
- Title
- Depression and Anxiety Risk in Acne Patients with PCOS Treated With Oral Contraceptives and/or Spironolactone: A 5-Year Retrospective Cohort Study using the TrinetX database
- Creators
- Caitlyn Curley - Drexel UniversityErum Ilyas - Drexel University
- Publication Details
- Journal of the American Academy of Dermatology, v 95(1), AB141
- Conference
- AAD 2026 Annual Meeting (Denver, Colorado, United States, 27 Mar 2026–31 Mar 2026)
- Publisher
- Elsevier
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- College of Medicine; Dermatology
- Other Identifier
- 991022197041804721