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Pinto J, Cera N, Pignatelli D. Psychological symptoms and brain activity alterations in women with PCOS and their relation to the reduced quality of life: a narrative review. J Endocrinol Invest 2024; 47:1-22. [PMID: 38485896 PMCID: PMC11196322 DOI: 10.1007/s40618-024-02329-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/03/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common feminine endocrine disorder, characterized by androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. The negative impact of symptoms on the quality of life (QoL) of patients is still not clear. PURPOSE The present review aimed at studying the impact of the symptoms, the psychological symptoms, and brain alterations in women with PCOS. METHODS A systematic search was undertaken for studies that assessed the impact of PCOS symptoms on QoL, psychological symptoms, and brain alterations in PCOS patients. RESULTS Most of the information about QoL came from psychometric studies, which used culture-based questionnaires. Alterations of sleep quality, body image, and mood disorders can negatively affect the QoL of the patients. Sexual satisfaction and desire were affected by PCOS. Brain imaging studies showed functional alterations that are associated with impairments of visuospatial working memory, episodic and verbal memory, attention, and executive function. CONCLUSIONS Several factors can negatively influence the quality of life of the patients, and they are directly related to hyperandrogenism and the risk of infertility. In particular, obesity, hirsutism, acne, and the fear of infertility can have a direct impact on self-esteem and sexual function. Metabolic and psychiatric comorbidities, such as mood, anxiety, and eating disorders, can affect the well-being of the patients. Moreover, specific cognitive alterations, such as impairments in attention and memory, can limit PCOS patients in a series of aspects of daily life.
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Affiliation(s)
- J Pinto
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135, Porto, Portugal
- Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal
| | - N Cera
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135, Porto, Portugal
- Research Unit in Medical Imaging and Radiotherapy, Cross I&D Lisbon Research Center, Escola Superior de Saúde da Cruz Vermelha Portuguesa, Lisbon, Portugal
| | - D Pignatelli
- Department of Endocrinology, Centro Hospitalar Universitário de São João, 4200-319, Porto, Portugal.
- Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal.
- Department of Biomedicine, Faculty of Medicine at University of Porto, Porto, Portugal.
- IPATIMUP Research Institute, Porto, Portugal.
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Nasiri-Amiri F, Faramarzi M, Omidvar S, Alizadeh-Navaei R. Depression and anxiety in adolescents and young women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Adolesc Med Health 2023:ijamh-2022-0065. [PMID: 37158791 DOI: 10.1515/ijamh-2022-0065] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 04/04/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES To evaluate the depression and anxiety symptoms, or both in adolescents and young women with polycystic ovary syndrome (PCOS) to those without PCOS. CONTENTS A comprehensive electronic search was conducted to identify observational studies on PCOS patients (January 1991-December 2020). The population study included adolescents and young women (14-29 years of age) in two groups of cases (with PCOS) and controls (without PCOS) who were diagnosed with PCOS using the Rotterdam or National Institutes of Health criteria (NIH). Symptoms of depression, anxiety, or both, reported separately, were of interest. Mean (SD) of depression or anxiety symptoms, or both, as measured by a quantitatively validated scale for both the case and control groups. All eligible studies were quality assessed using the Newcastle-Ottawa Scale (NOS) tool. The initial database search resulted in the discovery of 1,582 papers, of which 806 were selected after screening the titles and abstracts and removing duplicates. A total of 49 papers were found to be suitable for full-text reading. This meta-analysis included ten studies comprising 941 adolescent/young women (391 with PCOS and 550 without PCOS). The standard mean difference (SMD) and its corresponding confidence interval (CI) at 95 % were used to compare depression or anxiety symptoms, or both, between two groups. SUMMARY AND OUTLOOK The results, which included 192 cases, demonstrated that adolescents/young women with PCOS had significantly more depressive symptoms than those without PCOS (n=360) (SMD 0.72; 95 % CI, 0.09-1.34; Z=2.25, p=0.025; Heterogeneity: I2=89.7 %; p=0.000). Also, the results which included 299 cases demonstrated that adolescents/young women with PCOS had significantly more anxiety symptoms than those without PCOS (n=421) (SMD 0.59; 95 % CI, 0.13-1.05; Z=2.51, p=0.012; Heterogeneity: I2=86.1 %; p=0.000). This meta-analysis demonstrates that adolescent/young women with PCOS have significantly more depression or anxiety symptoms than those without PCOS.
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Affiliation(s)
- Fatemeh Nasiri-Amiri
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I. R. Iran
| | - Mahbobeh Faramarzi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Reproductive Health, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Midwifery School of Nursing & Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Reza Alizadeh-Navaei
- Biomedical Sciences, Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Donbaloğlu Z, Tuhan H, Çoban ÖG, Kızılay DÖ, İsmailoğlu E, Önder A, Acar S, Bedel A, Çetiner EB, Singin B, Erdem H, Parlak M. Hyperandrogenism correlates with psychological symptoms in adolescents with polycystic ovary syndrome. Clin Pediatr Endocrinol 2022; 31:68-76. [PMID: 35431449 PMCID: PMC8981047 DOI: 10.1297/cpe.2022-0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/26/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to analyze the depressive and anxiety states of adolescent girls with
polycystic ovary syndrome (PCOS). This was a cross-sectional, multicenter, case–control
study. A total of 100 participants (PCOS group, 51; control group, 49) aged 13–18 yr were
included in the study. Body mass index was higher in patients with PCOS (P = 0.002). In
the PCOS group, 28.5% of the patients had moderate-to-severe depressive symptoms, whereas
the incidence was lower in controls (8.3%, P = 0.021). The State-Trait Anxiety Inventory
(STAI)-State, STAI-Trait, and physical, psychosocial, and total Pediatric Quality of Life
Inventory PedsQL scores were higher in the PCOS group, suggesting that anxiety was more
common and the quality of life was worse in patients with PCOS than in healthy
participants (P = 0.01, P = 0.03, P = 0.02, P = 0.046, and P = 0.047, respectively). The
serum free testosterone (fT) levels were positively correlated with the depression and
anxiety scores and negatively correlated with the psychosocial PedsQL scores. In
conclusion, adolescent girls diagnosed with PCOS demonstrated higher depressive and
anxiety symptoms and lower psychosocial quality of life scores than their healthy
counterparts. A relationship was found between the fT level and all psychological
measures.
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Affiliation(s)
- Zeynep Donbaloğlu
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Hale Tuhan
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Özge Gizli Çoban
- Department of Child and Adolescent Psychiatry, Akdeniz University Hospital, Antalya, Turkey
| | - Deniz Özalp Kızılay
- Department of Pediatric Endocrinology, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Eren İsmailoğlu
- Department of Radiology, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Arif Önder
- Department of Child and Adolescent Psychiatry, Akdeniz University Hospital, Antalya, Turkey
| | - Sezer Acar
- Department of Pediatric Endocrinology, Behçet Uz Children Hospital, İzmir, Turkey
| | - Aynur Bedel
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Ebru Barsal Çetiner
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Berna Singin
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
| | - Harun Erdem
- Department of Child and Adolescent Psychiatry, Bakırçay University Çiğli Training and Research Hospital, Izmir, Turkey
| | - Mesut Parlak
- Department of Pediatric Endocrinology, Akdeniz University Hospital, Antalya, Turkey
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Tonellotto Dos Santos J, Escarião da Nóbrega J, Serrano Mujica LK, Dos Santos Amaral C, Machado FA, Manta MW, Rizzetti TM, Zanella R, Fighera R, Antoniazzi AQ, Gonçalves PBD, Comim FV. Prenatal Androgenization of Ewes as a Model of Hirsutism in Polycystic Ovary Syndrome. Endocrinology 2018; 159:4056-4064. [PMID: 30376052 DOI: 10.1210/en.2018-00781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/24/2018] [Indexed: 02/04/2023]
Abstract
The main clinical feature associated with hyperandrogenism in polycystic ovary syndrome (PCOS) in humans is hirsutism, where hair increases its length, pigmentation, and particularly its diameter. Currently, it is not known whether PCOS animal models also exhibit changes in the hair. Therefore, the aim of this study was to explore the wool characteristics in sheep prenatally androgenized (PA) with testosterone propionate. After 4 and 13 months of life, wool was collected from the top of the shoulder of both females and males (both androgenized and controls). The offspring sheep were followed for up to 19 months of life to evaluate testosterone and androstenedione serum levels by ultra-high-performance liquid chromatography-tandem mass spectrometry, determine insulin and glucose response to intravenous glucose tolerance test, and address estrus cyclicity during the second breeding season. PA male animals showed a reduction in wool fiber diameter at 4 months of age compared with controls (P = 0.02) but not at 13 months, whereas PA females showed increased hair diameter at 13 months (P = 0.002), with no difference at 4 months. No substantial changes in other hair parameters (length, color, and medullation) were identified. In addition, increased levels of serum testosterone were observed in PA female sheep compared with controls at 12 months (P = 0.03). Our results indicate for the first time, to our knowledge, that changes in wool fiber diameter observed in PA ewes replicate, at the translational level, the increase in hair diameter in hirsute women with PCOS.
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Affiliation(s)
- Joabel Tonellotto Dos Santos
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Jandui Escarião da Nóbrega
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Lady Katerine Serrano Mujica
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Carolina Dos Santos Amaral
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Fabrício Amadori Machado
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Manuela W Manta
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Tiele Medianeira Rizzetti
- Laboratory of Pesticide Analysis (LARP), Department of Chemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Renato Zanella
- Laboratory of Pesticide Analysis (LARP), Department of Chemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Rafael Fighera
- Department of Pathology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Alfredo Quites Antoniazzi
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Paulo Bayard Dias Gonçalves
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
| | - Fabio Vasconcellos Comim
- Laboratory of Biotechnology and Animal Reproduction (BioRep), Federal University of Santa Maria, Santa Maria, Brazil
- Department of Clinical Medicine, Health Science Center, Federal University of Santa Maria, Santa Maria, Brazil
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Sadeeqa S, Mustafa T, Latif S. Polycystic Ovarian Syndrome-Related Depression in Adolescent Girls: A Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2018; 10:55-59. [PMID: 29962792 PMCID: PMC5998697 DOI: 10.4103/jpbs.jpbs_1_18] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Polycystic ovarian syndrome (PCOS), a common endocrinal disorder of reproductive age characterized by heterogeneous complications, is nowadays prevailing among females at adolescent stage. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can occur in women with PCOS. In adolescents, infrequent or absence of menstruation may raise chances for this condition. The increased prevalence of PCOS among general population throughout the world is found to be 5%-10% in the women of reproductive age, and about 40% women with PCOS experience depression, particularly young girls. The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications. Depression and anxiety are common in women with PCOS but are often overlooked and therefore left untreated. Along with the physical disturbances, many mental problems are also associated with PCOS. Therefore, PCOS not only has problems associated with reproduction but also has associated crucial metabolic and psychological health risks with increasing age of the patients. Because of the increased number of cases with PCOS around the world in present times, with prominent symptom of, specifically, depression at the adolescent stage, it is important to highlight the disease.
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Affiliation(s)
- Saleha Sadeeqa
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Tehreem Mustafa
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Sumaira Latif
- Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
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Pfister G, Rømer K. "It's not very feminine to have a mustache": Experiences of Danish women with polycystic ovary syndrome. Health Care Women Int 2016; 38:167-186. [PMID: 27630044 DOI: 10.1080/07399332.2016.1236108] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This article explores women's lived experiences with polycystic ovary syndrome (PCOS) on the basis of semistructured interviews with 21 Danish women. It provides insights about the problems that they experienced and how they coped with PCOS. The interviews revealed that they were highly influenced by society's femininity norms. Many of them perceived their bodies as "different" because of the symptoms of PCOS, namely, hirsutism. They used different strategies to live up to body ideals and cope with the symptoms. However, hirsutism had a decisive negative influence on the women's everyday lives, particularly with regard to male partners and sexual relations.
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Affiliation(s)
- Gertrud Pfister
- a Department of Nutrition, Exercise, and Sports, Faculty of Science , University of Copenhagen , Copenhagen , Denmark
| | - Kristine Rømer
- a Department of Nutrition, Exercise, and Sports, Faculty of Science , University of Copenhagen , Copenhagen , Denmark
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Zheng Y, Stener-Victorin E, Ng EHY, Li J, Wu X, Ma H. How does acupuncture affect insulin sensitivity in women with polycystic ovary syndrome and insulin resistance? Study protocol of a prospective pilot study. BMJ Open 2015; 5:e007757. [PMID: 25941189 PMCID: PMC4420969 DOI: 10.1136/bmjopen-2015-007757] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Hyperinsulinaemia and insulin resistance (IR) are key features of polycystic ovary syndrome (PCOS) and metabolic syndrome. The effect of 5 weeks of acupuncture treatment has been investigated in a completed prospective pilot trial (Clinicaltrials.gov: NCT01457209), and acupuncture with electrical stimulation applied to insulin-resistant rats with dihydrotestosterone-induced PCOS was shown to improve insulin sensitivity. Therefore, we now aim to conduct a prospective pilot study to evaluate whether using the same acupuncture treatment protocol given over a longer period of time (6 months) than in the previous pilot trial will improve insulin sensitivity in women with PCOS and IR. Our hypothesis is that acupuncture with combined manual and low-frequency electrical stimulation of the needles will improve insulin sensitivity in women with PCOS and IR. METHODS/ANALYSIS This is a prospective pilot trial. A total of 112 women with PCOS and IR will be recruited and categorised according to their body mass index (BMI) as normal weight (BMI=18.5-23 kg/m(2)) or as overweight/obese (BMI>23 kg/m(2)). Acupuncture will be applied three times per week for 6 months at 30 min per treatment. The primary outcome will be the change in insulin sensitivity before and after 6 months of acupuncture treatment, as measured by an oral glucose tolerance test. ETHICS/DISSEMINATION Ethical approval of this study has been granted from the ethics committee of the First Affiliated Hospital of Guangzhou Medical University (No. 2013039). Written and informed consent will be obtained from each patient before any study procedure is performed, according to good clinical practice. The results of this trial will be disseminated in a peer-reviewed journal and presented at international congresses. TRIAL REGISTRATION NUMBERS NCT02026323 and ChiCTR-OCH-13003921.
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Affiliation(s)
- Yanhua Zheng
- Research Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, China
- Department of Traditional Chinese Medicine, The Fourth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | - Ernest H Y Ng
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, Hong Kong
| | - Juan Li
- Research Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, China
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoke Wu
- Department of Gynecology, First Affiliated Hospital National Key Discipline, Specialty and Trial Base Heilongjiang University of Chinese Medicine, China
| | - Hongxia Ma
- Research Institute of Integrated Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, China
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Banting LK, Gibson-Helm M, Polman R, Teede HJ, Stepto NK. Physical activity and mental health in women with polycystic ovary syndrome. BMC WOMENS HEALTH 2014; 14:51. [PMID: 24674140 PMCID: PMC3986680 DOI: 10.1186/1472-6874-14-51] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/20/2014] [Indexed: 12/19/2022]
Abstract
Background Physical activity is prescribed as a component of primary management for Polycystic Ovary Syndrome (PCOS). This study investigates the association between physical activity and mental health as well as the exercise barriers, motivators and support providers for younger women with and without PCOS to assist in physical activity uptake and prescription for these women. Methods Women aged 18-50 years with (n = 153) and without PCOS (n = 64) completed a questionnaire at one time point. The questionnaire included the Hospital Anxiety and Depression Scale and a survey regarding levels of physical activity, physical activity barriers, motivators and supports. A MANCOVA assessed associations between physical activity, PCOS and mental health (specifically depression and anxiety). Descriptive and Chi square goodness of fit statistics assessed the differences in perceived barriers, motivators and support providers amongst women with and without PCOS. Results Women with PCOS displayed higher severity of depression (F(1,210) = 8.32, p = 0.004) and anxiety (F(1,210) = 17.37, p < 0.001) symptoms compared to controls. Overall, for physically active women, depression was significantly less severe than in their inactive counterparts (F(2,210) = 13.62, p < 0.001). There were no differences in anxiety by physical activity status and no interaction effects between PCOS and activity status for depression or anxiety. Women with PCOS were more likely to report a lack of confidence about maintaining physical activity (Χ2 = 3.65; p = 0.046), fear of injury (Χ2 = 4.08; p = 0.043) and physical limitations (Χ2 = 11.92; p = 0.001) as barriers to physical activity and were more likely to be motivated to be active to control a medical condition (Χ2 = 7.48; p = 0.006). Women with PCOS identified more sources of support compared to women without PCOS. Conclusions Physical activity is associated with lower depression in women with PCOS and differences exist in the self-reported physical activity barriers, motivators and support providers, compared to controls. Being more active may offer mental health benefits in managing PCOS. Prescribing physical activity to women with PCOS should be individualized and consider both common and PCOS-specific barriers and motivators for successful engagement.
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Affiliation(s)
| | | | | | | | - Nigel K Stepto
- Institute of Sport Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia.
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Sexual dysfunction assessment and hormonal correlations in patients with polycystic ovary syndrome. Int J Impot Res 2013; 25:127-32. [DOI: 10.1038/ijir.2013.2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 11/30/2012] [Accepted: 01/16/2013] [Indexed: 01/23/2023]
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Co-involvement of psychological and neurological abnormalities in infertility with polycystic ovarian syndrome. Arch Gynecol Obstet 2011; 284:773-8. [DOI: 10.1007/s00404-011-1947-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 06/03/2011] [Indexed: 01/31/2023]
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Deeks AA, Gibson-Helm ME, Paul E, Teede HJ. Is having polycystic ovary syndrome a predictor of poor psychological function including anxiety and depression? Hum Reprod 2011; 26:1399-407. [PMID: 21436137 DOI: 10.1093/humrep/der071] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The impact of metabolic and reproductive features of polycystic ovary syndrome (PCOS) compromises psychological functioning. We investigated factors associated with negative psychological functioning to determine whether they were predictive of anxiety and depression in PCOS. METHODS A cross-sectional study was performed by questionnaire in 177 women with PCOS (mean ± SD age 32.8 ± 7.8 years) and 109 healthy controls (mean age 41.9 ± 15.4 years). Main outcome measures were anxiety and depression, measured using the Hospital Anxiety Depression Scale (HADS) and Multidimensional Body-Self Relations Questionnaire (MBSRQ), respectively. RESULTS Women with PCOS, compared with control women, had a higher mean anxiety HADS score (9.5 ± 3.9 versus 6.5 ± 3.6; P < 0.001), a higher mean depression score (5.7 ± 3.7 versus 3.3 ± 3.1; P < 0.001) and more negative body image in 7 out of 10 subscales of the MBSRQ. Multivariate regression analysis in PCOS showed that anxiety was predicted by self-worth (P < 0.0001), health evaluation (P = 0.005), time taken to diagnose PCOS (P = 0.003) and age (P = 0.02), while in control women, anxiety was predicted by self-worth (P = 0.009), health evaluation (P = 0.001) and rural living (P = 0.03). Depression in PCOS was predicted by self-worth (P = 0.0004), quality of life (QOL) (P = 0.004), fitness orientation (P = 0.002), appearance evaluation (P = 0.001) and time to diagnosis (P = 0.03) and in women without PCOS, by self-worth (P < 0.0001), QOL (P < 0.0001), illness orientation (P = 0.001) and appearance orientation (P = 0.02). CONCLUSIONS Women with PCOS have increased anxiety, depression and negative body image compared with women without PCOS. In women with or without PCOS, body image and self-worth are predictors of both anxiety and depression, while QOL also predicts only depression. Time taken to diagnose PCOS is associated with poor psychological functioning.
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Affiliation(s)
- A A Deeks
- The Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Locked Bag 29, Clayton, Victoria 3168, Australia.
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Alvarez-Blasco F, Luque-Ramírez M, Escobar-Morreale HF. Obesity impairs general health-related quality of life (HR-QoL) in premenopausal women to a greater extent than polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf) 2010; 73:595-601. [PMID: 20618344 DOI: 10.1111/j.1365-2265.2010.03842.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Obesity is frequently associated with the polycystic ovary syndrome (PCOS) and both conditions may impact on the health-related quality of life (HR-QoL) of affected patients. We aimed to estimate the relative impact of obesity and PCOS on the general HR-QoL of premenopausal women. DESIGN Case-control study. PATIENTS Consecutive overweight and obese premenopausal women seeking advice for weight loss, of whom 32 were diagnosed with PCOS and 72 had no evidence of androgen excess and were considered controls. MEASUREMENTS Spanish versions of the Short Form 36 Health Survey (SF-36) questionnaire and the Nottingham Health Profile (NHP) were self-administered by the women. RESULTS Patients with PCOS and controls had similar body mass index, yet controls were older. General HR-QoL mean scores were similar in both groups, yet patients with PCOS scored worse in the role-emotional item of SF-36, and controls scored worse in the pain item of NHP. Increasing grades of obesity, on the contrary, were associated with worse scores in the NHP, and SF-36 items related to general and physical aspects of HR-QoL. When compared with the standards established for the Spanish general population, both patients with PCOS and controls frequently presented with abnormal scores, yet only increasing grades of obesity were associated with more frequent abnormal scoring. CONCLUSIONS Obesity impaired general HR-QoL to a greater extent than PCOS in overweight and obese premenopausal women.
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Affiliation(s)
- Francisco Alvarez-Blasco
- Department of Endocrinology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, E-28034, Madrid, Spain
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Moran L, Gibson-Helm M, Teede H, Deeks A. Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options. J Psychosom Obstet Gynaecol 2010; 31:24-31. [PMID: 20050767 DOI: 10.3109/01674820903477593] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM To assess psychological features in young women with and without PCOS. METHODS Observational, cross-sectional pilot study in young women aged 18-25 with (n = 24) or without (n = 22) PCOS (age: 22.41 +/- 0.39 vs. 21.95 +/- 0.47 years, p = 0.46; BMI: 29.17 +/- 1.54 vs. 22.05 +/- 0.83 kg/m(2), p = 0.0003). The main outcome measures were quality of life, anxiety, depression, risk perception and fears on future health. RESULTS Women with PCOS demonstrated worsened quality of life (p = 0.033) and greater anxiety (p = 0.01) and depression (p = 0.023) than women without PCOS related to BMI status. Women with PCOS were more likely to perceive themselves as at risk of obesity (p = 0.012) and infertility (p < 0.0001), and perceived greater importance in reducing future risk of prediabetes (p = 0.027), gestational diabetes (p = 0.039), type 2 diabetes (p = 0.01), heart disease (p = 0.005), obesity (p = 0.0007) and infertility (p = 0.023) than women without PCOS. Women with PCOS were more likely to have fears about future health related to weight gain (p = 0.045), loss of femininity (p = 0.035), loss of sexuality (p = 0.003) and infertility (p = 0.019) than women without PCOS. CONCLUSIONS Worsened quality of life, anxiety and depression in young women with PCOS is related to BMI. Risk perception is appropriately high in PCOS, yet perceived risks of future metabolic complications are less common than those related to weight gain and infertility.
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Affiliation(s)
- Lisa Moran
- The Jean Hailes Foundation for Women's Health Research Group, Monash University, Clayton, Australia.
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Rutherford T. Regulation and its impact on clinical practice. HUM FERTIL 2008; 11:129-30. [PMID: 18925470 DOI: 10.1080/14647270802402122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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