Mood Disorders in Patients With Polycystic Ovary Syndrome
In all, 300 women with PCOS were included in the study during the six months enrollment. The mean (SD) age of patients was 26.5 (4.44) years. The majority of women had education beyond high school (72.7%, n = 218). More than two-thirds of patients had never been pregnant nor had successfully carried a pregnancy to term and have abnormal menstruation. Socio-economic and clinical characteristic of the patients are presented in Table 1.
Of the participants, 32% (n = 96) demonstrated elevated HADS anxiety scores (i.e. HADS anxiety subscale ≥11) and 5% (n = 15) showed elevated HADS depression scores (i.e. HADS depression subscale ≥11). There was 15% (n = 45) who scored above the cut-offs (≥11) for both anxiety and depression (Figure 1).
(Enlarge Image)
Figure 1.
Frequency distribution of participants presenting with normal HADS (unaffected, anxiety, depression, or coexistence anxiety and depression.
Subsequently, to assess the impact of depression and anxiety symptoms on quality of life, the sample was divided into four subgroups based on the HADS scores (Figure 2). All groups with higher score on the HADS demonstrated markedly reduced psychological quality of life (F = 42.99, P < 0.001, Figure 2). Post hoc comparisons revealed a significantly lower quality of life in PCOS women with depression (P <0.001) and with anxiety (P < 0.001) compared with unaffected participants. The lowest mental health quality of life however, was observed in participants with coexistence anxiety and depression (post hoc Scheffe test for patients with anxiety and depression versus unaffected PCOS: P < 0.001).
(Enlarge Image)
Figure 2.
Comparison of sum scores of quality of life based on psychological function (unaffected, anxiety, depression or coexistence anxiety and depression) in PCOS patients.
Moreover, all groups with higher scores on the HADS demonstrated markedly reduced physical quality of life (F = 25.109, P < 0.001, Figure 2). Post hoc comparisons revealed a significantly lower quality of life in PCOS women with depression (P =0.04) and with anxiety (P < 0.001) compared with unaffected participants. The lowest physical quality of life, however, was observed in participants with coexistence anxiety and depression (post hoc Scheffe test for patients with anxiety and depression versus unaffected PCOS: P <0.001).
To determine the association between socio-demographical and (bio) clinical characteristics of PCOS with depression and anxiety, the data was further analyzed based on presence or absence of depression or anxiety among patients. There was no significant difference in the mean age, BMI and other demographic characteristics within groups (Table 2).
Compared with the non-depressed PCOS women, the depressed PCOS patients had significantly higher menstrual irregularities (P = 0.008). We found significant difference in FAI level between the depressed and non-depressed (p = 0.05)/anxious and non-anxious (p < 0.001) compared to non affected PCOS patients.
Results
Socio-demographic Characteristics and Clinical Symptoms
In all, 300 women with PCOS were included in the study during the six months enrollment. The mean (SD) age of patients was 26.5 (4.44) years. The majority of women had education beyond high school (72.7%, n = 218). More than two-thirds of patients had never been pregnant nor had successfully carried a pregnancy to term and have abnormal menstruation. Socio-economic and clinical characteristic of the patients are presented in Table 1.
Prevalence of Depression and Anxiety and Comparison for Quality of Life
Of the participants, 32% (n = 96) demonstrated elevated HADS anxiety scores (i.e. HADS anxiety subscale ≥11) and 5% (n = 15) showed elevated HADS depression scores (i.e. HADS depression subscale ≥11). There was 15% (n = 45) who scored above the cut-offs (≥11) for both anxiety and depression (Figure 1).
(Enlarge Image)
Figure 1.
Frequency distribution of participants presenting with normal HADS (unaffected, anxiety, depression, or coexistence anxiety and depression.
Subsequently, to assess the impact of depression and anxiety symptoms on quality of life, the sample was divided into four subgroups based on the HADS scores (Figure 2). All groups with higher score on the HADS demonstrated markedly reduced psychological quality of life (F = 42.99, P < 0.001, Figure 2). Post hoc comparisons revealed a significantly lower quality of life in PCOS women with depression (P <0.001) and with anxiety (P < 0.001) compared with unaffected participants. The lowest mental health quality of life however, was observed in participants with coexistence anxiety and depression (post hoc Scheffe test for patients with anxiety and depression versus unaffected PCOS: P < 0.001).
(Enlarge Image)
Figure 2.
Comparison of sum scores of quality of life based on psychological function (unaffected, anxiety, depression or coexistence anxiety and depression) in PCOS patients.
Moreover, all groups with higher scores on the HADS demonstrated markedly reduced physical quality of life (F = 25.109, P < 0.001, Figure 2). Post hoc comparisons revealed a significantly lower quality of life in PCOS women with depression (P =0.04) and with anxiety (P < 0.001) compared with unaffected participants. The lowest physical quality of life, however, was observed in participants with coexistence anxiety and depression (post hoc Scheffe test for patients with anxiety and depression versus unaffected PCOS: P <0.001).
Impact of Socio-demographical and (Bio) Clinical Characteristics of PCOS on Anxiety and Depression Risk
To determine the association between socio-demographical and (bio) clinical characteristics of PCOS with depression and anxiety, the data was further analyzed based on presence or absence of depression or anxiety among patients. There was no significant difference in the mean age, BMI and other demographic characteristics within groups (Table 2).
Compared with the non-depressed PCOS women, the depressed PCOS patients had significantly higher menstrual irregularities (P = 0.008). We found significant difference in FAI level between the depressed and non-depressed (p = 0.05)/anxious and non-anxious (p < 0.001) compared to non affected PCOS patients.
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