Threats to Feminine Identity as the Main Concern of Iranian Adolescents with Polycystic Ovary Syndrome: A Qualitative Study

The effectiveness of psychological interventions for reducing poor body image in endometriosis, PCOS and other gynaecological conditions: a systematic review and meta-analysis

Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [-0.20 -0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach.

Depression and Anxiety in Patients With Polycystic Ovary Syndrome: A Cross-Sectional Study in Saudi Arabia

INTRODUCTION

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of childbearing age. It causes irregular menstruation, infertility, acne vulgaris, androgenic alopecia, and hirsutism. It is associated with a higher risk of mental disorders. This study aimed to determine the prevalence of depression and anxiety among females with PCOS and the factors associated with these disorders.

METHODS

This cross-sectional study was conducted between 15th January and 19th November 2023. We invited Saudi women to do an online survey. We sent the survey link privately, got their permission, and explained the research to ensure privacy and reliability. Females with a previous psychiatric history were excluded. Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to assess depression, anxiety, and distress. One-way analysis of variance (ANOVA) and two-sample t-tests were used to identify determinants of depression and anxiety.

RESULTS

About 967 females participated, of whom 474 (49%) were married, and 358 (37%) had a healthy weight. About 367 (37.9%) of participants were diagnosed with PCOS, and it was associated with age (26-35 years), divorce, and family history of PCOS (p < 0.05). About 112 (30.5%) of PCOS patients experienced extremely severe depression, and 144 (39.2%) had extreme anxiety. People in the age range of 15-25 years had a higher risk of depression and stress (p < 0.05). Divorced participants faced a higher risk of depression, anxiety, and stress than singles (p < 0.05). Those advised on diet and healthy lifestyles exhibited a higher risk of depression, anxiety, and stress than those who were not (p < 0.05). Additionally, being overweight was associated with a higher risk of depression (p < 0.05).

CONCLUSION

The prevalence of PCOS was found to be 37.9% in our study, which may seem higher compared to the existing literature on PCOS. It is associated with being in the age group of 26-35 years, being divorced, and having a positive family history. Almost two-thirds of females with PCOS had depression, anxiety, and stress. Factors associated with the three disorders include divorce and management with diet and lifestyle modifications. Depression and stress were associated with young age. High body mass index (BMI) was associated with depression.

Polycystic ovary syndrome and body image concerns during adolescence

PURPOSE

This study aimed to compare body image concerns in adolescents with and without PCOS.

DESIGN AND METHODS

This cross-sectional study included 1076 adolescents, including 344 with PCOS and 732 without PCOS. The participants were asked to complete a comprehensive questionnaire that included demographic and reproductive parameters and the body image concerns inventory (BICI) which comprised two factors (1-dissatisfaction and embarrassment about one's appearance and 2-social function due to appearance concerns). Linear regression analysis was conducted to evaluate the effect of hyperandrogenism and/or abnormal uterine bleeding (AUB) and/or obesity on BICI and its domains both before and after adjustment for potential confounders.

RESULTS

The result showed that adolescents with PCOS had a worse total BICI score and its domains (p < 0.05). In multivariable-adjusted regression models, adolescents with PCOS were more likely to have a high body image concern (β = 0.05, P < 0.001), while those with high household income were less likely to have body image concern (β = -0.08, P = 0.004). Considering hyperandrogenism status, those with high household income were also less likely to have high body image concern (β = -0.08, P = 0.004), and age of menarche (β = -0.01, P = 0.013) were also inversely associated with total BICI score. Likewise, considering obese status, only high household income (β = -0.08, P = 0.004) was inversely associated with total BICI score. Also, considering menstrual irregularity status, high household income (β = -0.08, P = 0.005), and age of menarche (β = -0.01, P = 0.01) were inversely associated with the total BICI score.

CONCLUSION

Adolescents with PCOS had higher body image concerns. Apart from the being PCOS label, abnormal uterine bleeding was also a predictor of body image concern.

PRACTICAL IMPLICATIONS

Clinicians should pay attention to the greater influence of the PCOS label on altered body image in adolescents.