Risk of psychological burden in polycystic ovary syndrome: A case control study in Riyadh, Saudi Arabia

Comparison of premenstrual symptoms, psychological well-being, and nutritional status between Palestinian women with and without polycystic ovarian syndrome: a case-control study

BACKGROUND

Polycystic ovarian syndrome (PCOS) is a widely seen reproductive and endocrinological disorder. PCOS can exert substantial effects on many aspects of an individual's life, including reproductive health and psychological well-being. The objective of this study was to assess the nutritional status, premenstrual syndrome, and mental health of women affected by PCOS in comparison to women without PCOS.

METHODOLOGY

A case-control observational study in Palestine included 100 PCOS patients and 200 healthy women. The collected data included socio-demographic information, medical history, premenstrual syndrome, mental health, nutritional status, and lifestyle. Anthropometric measurement and the Mediterranean Diet Adherence Screener (MEDAS) were used to evaluate the nutritional status. The General Health Questionnaire (12-GHQ) was used to evaluate the state of mental health. Premenstrual syndrome (PMS) severity was evaluated using a validated Arabic premenstrual syndrome questionnaire.

RESULTS

The study's findings indicated that there was a statistically significant increase in the three dimensions of PMS among participants with PCOS, p < 0.05. Similarly, PCOS patients demonstrated elevated ratings across all aspects of mental health, p < 0.05. In terms of the other variables, it has been observed that PCOS patients have a notably greater prevalence of perceived sleep disturbances and decreased adherence to the Mediterranean diet. Regression analysis revealed that PCOS is associated with mental health problems indicated by a higher GHQ score (OR: 1.09; 95% CI: 1.03; 1.16, p < 0.05), lower adherence to the MD diet (OR: 0.86; 95% CI: 0.76; 0.98, p < 0.05), and pre-menstrual syndrome, especially the physical symptoms (OR: 1.06; 95% CI: 1.003; 1.12, p < 0.05) after adjusting for age, smoking, waist-hip ratio, and body mass index (BMI).

CONCLUSION

The study has linked polycystic ovary syndrome to negative mental health outcomes and an increased severity of premenstrual syndrome (PMS). Additional investigation is required in order to establish a causal association between polycystic ovary syndrome (PCOS) and lifestyle behaviors within the Palestinian population. Intervention and instructional studies are necessary to investigate the efficacy of management strategies in alleviating the effects of polycystic ovary syndrome (PCOS) on both physical and mental well-being.

New insights into the interaction between polycystic ovary syndrome and psychiatric disorders: A narrative review

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disease characterized by hyperandrogenism, ovulatory dysfunction, and ovarian polycystic changes, which combines with reproductive problems, metabolic disorders, and psychological disorders to exhibit a far-reaching impact on the physical and mental health of women. We reviewed previous research and discovered that psychiatric disorders are more common in PCOS patients and their children, potentially exacerbating the condition and creating a vicious loop. To understand the reasons, relevant articles were collected following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines from PubMed, Web of Science, and Cochrane Library, through December 2022. Evidence suggested that PCOS-related clinical manifestations, hyperandrogenism, insulin resistance, obesity, gut dysbiosis, and other variables may increase the risk of psychiatric disorders in patients. In turn, psychiatric disorders may aggravate the pathologic process of PCOS and increase the difficulty of the treatment. We systematically reported the mechanisms underlying the psychiatric disorders-PCOS interactions, intending to provide potential ways to break the vicious cycle and lay the groundwork for future research. However, research on PCOS and psychiatric disorders were still in initial stages, which limited the scope of this review. More studies are needed to further verify our findings.

A Comparative Study of Food Intake and Adipose Tissue Distribution in Saudi Women with Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS) is a frequent disorder that affects reproductive-aged women and has reproductive, metabolic, and psychosocial effects. This research was intended to investigate the comparison between food intake and adipose tissue distribution in Saudi women suffering from PCOS and a control group. To determine the sociodemographic variables, a case-control study was performed with patients from King Fahad Medical City's Reproductive Endocrine and Infertility Medicine Department (REIMD). The case-control study comprised 42 PCOS patients (PCOS-Ps) and 63 as a control group, all aged 20-45 years. Three-day records were collected from participants to estimate the nutrient intake of cases and controls. A body composition analyzer was used to measure body mass index (BMI), body fat (BF), and visceral fat (VF). Biochemical measurements were taken to determine the lipid profile, total testosterone, and serum vitamin D-25-OH. The women's frequency distribution based on sociodemographic characteristics revealed significant differences within and between the groups. The variations in dietary intake between the PCOS-P and control groups were primarily in terms of total calories, carbohydrates, niacin, and folate, all of which were significantly higher in the PCOS-P group. Dietary fiber, unsaturated fat, vitamin A, vitamin B12, calcium, phosphorus, and selenium, on the other hand, were significantly higher in the control group. A majority of both groups had significantly higher BMI (overweight or obese) and higher BF, but normal VF. According to the findings, testosterone levels in PCOS-Ps were significantly higher than in the control group, but vitamin D-25-OH and high-density-lipoprotein cholesterol (HDL-C) were significantly lower. Age, monthly income, cholesterol, low-density-lipoprotein cholesterol (LDL-C), and testosterone were the fundamental causes impacting women's anthropometric indices. In conclusion, although both groups were overweight or obese, and differences in calorie and nutrient intake, HDL-C, testosterone, and vitamin D-25-OH levels were observed. The study advises such population groups to limit their consumption of foods high in calories.

Molecular role of non-exonic variants in CALPAIN 10 gene in polycystic ovarian syndrome in Saudi women

Introduction

Non-diabetic women with polycystic ovarian syndrome (PCOS) often have abnormal insulin regulation. Calpain 10 (CALP10) is a biomarker of type 2 diabetes mellitus, with some of its single-nucleotide polymorphisms (SNPs) influencing PCOS development.

Methods

In this case-control study on 90 women each with and without PCOS, we explored the molecular role of five CALP10 SNPs using biochemical parameters and Sanger sequencing analyses.

Results

Different genetic models, genotypes, and allele frequencies were significantly associated with UCSNP-19 (rs3842570; p=0.01), UCSNP-44 (rs2975760; p=0.009), UCSNP-56 (rs2975762; p<0.0001), and UCSNP-63 (rs5030952; p=0.0003) in women with PCOS. The multiple logistic regression model showed a strong association of CALP10 SNPs with fasting blood glucose (p<0.001). ANOVA showed significant associations with various biochemical parameters such as FSH (p=0.0001) in UCSNP-19 (rs3842570), FI (p=0.002), TG (p=0.01) in UCSNP-56 (rs2975762) and FBG (p=0.001), FI (p=0.004), FSH (p=0.02) & LDLc (p=0.04) in UCSNP-63 (rs5030952) SNPs. Haplotype analysis also revealed significant associations between different combinations of alleles in the studied 5 SNPs in women with PCOS (p<0.05). Generalized multifactor dimensionality reduction analysis showed the best gene-gene interactions among the five SNPs in CALP10I (p<0.05). However, dendrogram and graphical depletion models found no strong association in women with PCOS.

Conclusion

In conclusion, this study confirms rs3842570, rs2975760, rs2975767, and rs5030952 SNPs in CALP10 gene is associated in diagnosed PCOS women in the Saudi Arabia.

Impact of Vitamin D Deficiency on Mental Health in University Students: A Cross-Sectional Study

Students pursuing a university education are vulnerable to psychological burdens such as depression, anxiety, and stress. The frequency of vitamin D deficiency, on the other hand, is extensively recognized worldwide, and vitamin D regulates various neurological pathways in the brain that control psychological function. Therefore, the goal of this cross-sectional study was to determine the relationship between vitamin D deficiency and psychological burden among university students in Riyadh, Saudi Arabia. During March-May 2021 in Riyadh, a cross-sectional comparative study survey was delivered to university students. The DASS-21 scale was used to determine the severity of the psychological burden. Both univariate and binomial regression analyses were conducted to analyze the level of significance and influence of several factors on the development of psychological burden. The data were analyzed with SPSS-IBM, and a p value of <0.05 was considered significant. Of the 480 students recruited for the study, 287 (59.79%) had a vitamin D deficiency. Significantly (p = 0.048), a high proportion of the vitamin D-deficient students attained a low or moderate GPA compared to the control cohort. The prevalence of depression, anxiety, and stress among the vitamin D-deficient students was 60.35%, 6.31%, and 75.08%, respectively, which was significantly (p < 0.05) different from the control group. The odds of developing depression (OR = 4.96; CI 2.22-6.78; p < 0.001), anxiety (OR = 3.87; CI 2.55-6.59; p < 0.001), and stress (OR = 4.77; CI 3.21-9.33; p < 0.001) were significantly higher in the vitamin D-deficient group. The research shows a strong association between psychological stress and vitamin D deficiency. To promote the mental health and psychological wellbeing of university students, it is critical to create awareness about the adequate consumption of vitamin D. Additionally, university students should be made aware of the likelihood of a loss in academic achievement owing to vitamin D deficiency, as well as the cascade effect of psychological burden.

Role of polycystic ovarian syndrome in developing psychological burden in Saudi Arabian females: A case control study

It is well known that polycystic ovarian syndrome (PCOS) may elevate psychological problems in patients, but there is a scarcity of the studies among Saudi Arabian population. This research was designed to investigate the influence of PCOS on the development of psychological load in terms of depression, anxiety, and stress in comparison to normal women who have no PCOS. Further, a correlation of psychological distress in PCOS females was done with their educational level. This is case-control research carried out in one of Riyadh's multispecialty hospitals. In the PCOS patients and control groups (each with 84 samples), samples were collected using convenience sampling and a simple random approach, respectively. The psychological burden was determined using DASS-21. The data obtained were analyzed using SPSS-IBM 25. Most participants (52.9%) were between the ages of 26 and 35 and had a university education (68.4%). A significantly higher percentage of PCOS patients (P = 0.001) had irregular menses, hirsutism, infertility, and acne in comparison to the mothers without PCOS. There was a significantly higher possibility of depression (P = 0.003), anxiety (P = 0.016), and stress (P = 0.001) among PCOS patients than in control subjects. Among the psychological domain tested in the study, the risk of developing stress (odds ratio, OR = 8.32) was high when compared to depression (OR = 3.12) and anxiety (OR = 2.127) in PCOS patients. Furthermore, when compared to PCOS females with less education, a significantly lower number of university-educated PCOS females developed depression. The study demonstrates a high prevalence of psychological burden among the PCOS population. Higher education has been shown to help in alleviating depression in PCOS females. Meeting PCOS women's psychological needs will improve their overall health status.

Depression symptoms and quality of life in women with polycystic ovary syndrome

PURPOSE

To determine depression symptoms and quality of life in women with polycystic ovary syndrome (PCOS).

METHODS

The data were collected using the Participant Information Form, PCOS Quality of Life Questionnaire (PCOSQ-50), and Beck Depression Inventory (BDI). The study was conducted with 131 women.

FINDINGS

The average BDI score was found to be lower in women with PCOS who perceived their income as sufficient (p = 0.033) and who worked (p = 0.003) and was found to be higher in the participants who had hirsutism (p = 0.008) and acne (p = 0.045). The PCOSQ-50 average score was 178.15 ± 27.27 in women without depression symptoms and 139.14 ± 31.33 in women with depression symptoms. The PCOSQ-50 total score was higher in women without depressive symptoms (p = 0.000).

PRACTICE IMPLICATIONS

Healthcare professionals should evaluate depression symptom levels using standard measurement tools and provide appropriate counseling.

Cutaneous Manifestations and Hormonal Changes Among Polycystic Ovary Syndrome Patients at a Tertiary Care Center

Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder affecting 5%-10% of women worldwide. PCOS patients usually present with cutaneous manifestations of hyperandrogenism, such as acne, hirsutism, and androgenic alopecia.

Objective: To estimate the prevalence of dermatological manifestations and their association with hormonal changes in PCOS patients. In addition, this study aimed to estimate the prevalence of comorbidities associated with PCOS and to demonstrate the referral pattern among Dermatology, Gynecology, and Primary Health Care (PHC).

Methods: This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. All PCOS patients who attended KAMC from 2016 to 2021 were included. Data were collected through a retrospective chart review of the electronic medical record system (BestCare) and by utilizing a structured data collection sheet.

Results: A total of 447 female patients were diagnosed with PCOS with a median age of 29 years and a median BMI of 28.76 kg/m².The prevalence of cutaneous manifestations among patients was 68%. Hirsutism (47.3%), acne vulgaris (40.6%), and androgenic alopecia (20.3%) were the most common manifestations. The most common hormonal abnormalities were raised luteinizing hormone (LH) levels in 220 (49.1%) patients and raised LH/follicle-stimulating hormone (FSH) ratio in 159 (35.5%) patients. FSH, LH/FSH ratio, and age were significant predictors for acne vulgaris (P-value=0.01, 0.04, and 0.01, respectively). Obesity (44.20%), infertility (25.70%), and dyslipidemia (17%) were the most common comorbidities in our sample. Most patients' first visits and follow-ups were in PHC. 

Conclusion: The prevalence of cutaneous manifestations among PCOS patients is relatively high and plays a significant role in making the diagnosis. Therefore, physicians across multiple specialties need to be more aware of the full spectrum of PCOS presentations to alleviate it from its under-diagnosed status.

Impact of polycystic ovary syndrome on eating behavior, depression and health related quality of life: A cross-sectional study in Riyadh

Background & objectives

Polycystic ovary syndrome (PCOS) is the most common endocrinal disorder, and the greatest cause of infertility in women. Despite availability of individual data on impact of multiple endocrinal, reproductive and even metabolic factors in PCOS individuals, the data on the co-existence of BED and depression in PCOS patients with its relationship on the quality of life in Saudi Arabian females is not found. Hence this study is aimed to elucidate the implication of PCOS on eating behaviour, induction of depression and general health quality in Saudi Arabian population of Riyadh.

Materials and methods

This is a cross-sectional study carried out in multiple health facilities of Riyadh from January to March 2019. The study samples (494) were recruited by convenience sampling and administered validated questionnaire by trained research participants. The data obtained was analysed by binary logistic regression using SPSS-IBM 25.

Results

Of the total 494 women participated in the study, 23.48% (116) were PCOS individuals. The odds of developing abnormal health related quality of (HRQ) in patients with PCOS was significantly (P = 0.000, OR = 3.472) high when compared to non-PCOS participants. The odds of showing high binge eating disorder (BED, P = 0.007, OR = 2.856) and depression (P = 0.000, OR = 2.497) scores in PCOS participants were significantly more than patients who were not having PCOS. Out of the three parameters studied, abnormal health related quality of life possessed a higher influence of PCOS compared to depression and abnormal eating behavior.

Interpretation & conclusion

In conclusion, the present study shows that women with PCOS are at a significant risk for depressive disorders, disorganized eating behavior and impaired quality of life. Therefore, necessary care and screening is required to minimize the impact of PCOS on already burdened individuals.

COVID-19 and Psychological Health of Female Saudi Arabian Population: A Cross-Sectional Study

The influence of the COVID-19 pandemic is unprecedented on physical and mental health. This study aimed to determine the impact of the COVID-19 event on mental health among Saudi Arabian females of Riyadh by a cross-sectional study design. The samples of the study were recruited using convenience and snowball sampling methods. The questionnaire is composed of items related to sociodemographic profile, general mental status, negative attitude scale, impact of event (COVID-19 pandemic) scale (R) and negative health impact. The data obtained were analyzed using multivariate regression analysis. Out of the 797 samples (34.58 ± 12.89 years), 457 (57.34%) belonged to an age group of ≥25 years. The average BMI of the participants was 26.73 (kg/m²). Significantly (p = 0.000), a large proportion of the participants were overweight and unemployed. Age group (>25 years) have more odds for abnormal mental status (OR; 1.592), development of negative attitudes (OR; 1.986), the intense impact of COVID-19 events (OR; 1.444) and susceptibility to attain negative health impacts (OR; 1.574). High body weight is another risk factor for altered mental status, negative attitude and developing impact of COVID-19 quickly. Overall, the COVID-19 pandemic was directly associated with stress (53%), anxiety (63%) and depression (44%) in our sample population. There is an urgent need for psychological counseling for the distressed population.