Is Having Polycystic Ovary a Predictor of Poor Psychological Function Including Anxiety and Depression

The characteristic metabolic and reproductive features of polycystic ovary syndrome (PCOS) are a physical and psychological burden. Although some studies have suggested that women with PCOS have higher rates of depression and anxiety compared with those in the general population, existing evidence is inconsistent and inconclusive because of limitations in research methodology and design. Possible factors contributing to anxiety and depression in women with PCOS are poorly understood. The aim of this cross-sectional study was to determine whether PCOS is predictive of anxiety and depression and to investigate whether predictive factors associated with poor psychological function are predictive for anxiety and depression in women with PCOS. Responses to a questionnaire were compared in 177 women diagnosed with PCOS (mean age: 32.8 ± 7.8 years) and 109 healthy controls without diagnosed PCOS (mean age: 41.9 ± 15.4 years). Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Body image was assessed using the Multidimensional Body-Self Relations Questionnaire. The association of demographic and psychological factors with the presence of anxiety and depression was assessed with univariate and multivariate analyses. There were significant differences between women with and without PCOS with respect to anxiety, depression, and body image. Women with PCOS had a higher mean anxiety Hospital Anxiety and Depression Scale score (9.5 ± 3.9 vs. 6.5 ± 3.6; P < 0.001), a higher mean depression score (5.7 ± 3.7 vs. 3.3 ± 3.1; P < 0.001), and more negative body image in 7 of 10 Multidimensional Body-Self Relations Questionnaire subscales. Multivariate analysis showed that independent predictive factors for anxiety in women with PCOS were self-worth (P < 0.0001), health evaluation (P = 0.005), time taken to diagnose PCOS (P = 0.003), and age (P = 0.02), whereas predictive factors for anxiety in the controls were self-worth (P = 0.009), health evaluation (P = 0.001), and rural living (P = 0.03). Independent predictive factors for depression in women with PCOS were 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), whereas in the control women, independent predictive factors for depression were self-worth (P < 0.0001), QOL (P < 0.0001), illness orientation (P = 0.001), and appearance orientation (P = 0.02). These findings are consistent with previous published data showing that anxiety and depression are more prevalent in women with PCOS than in those without PCOS. Negative self body determination also appears to be associated with increased prevalence of anxiety and depression. The data suggest that body image and self-worth are predictors of both anxiety and depression among women with and without PCOS, whereas QOL is predictive only for depression.