Increased Anxiety, Depression in Women With PCOS

Medscape

25-07-2025

TOPLINE:
Compared with control women, those with polycystic ovary syndrome (PCOS) had a higher risk for anxiety and depression, with high total perceived stress, a case-control trial showed.
METHODOLOGY:
Researchers conducted a prospective case-control trial including 31 non-infertile women with PCOS (age, 18-40 years) and 31 healthy control women with regular menstrual cycles and no clinical/biochemical hyperandrogenism and who were off hormonal contraception.
Participants underwent clinical and hormonal evaluation, including measures of BMI, Ferriman-Gallwey hirsutism score, Global Acne Grading System, and transvaginal ultrasound for polycystic ovarian morphology (PCOM). Additionally, total/free testosterone, dehydroepiandrosterone sulphate (DHEA-S), luteinising hormone (LH)/follicle-stimulating hormone, and anti-Müllerian hormone (AMH) levels were measured.
Psychological assessment was conducted using the Symptom Checklist-90-Revised (SCL-90-R) scale and three global categories, Global Severity Index (GSI; reflecting overall stress), Positive Symptom Total (PST; reflecting the total number of stress-inducing symptoms), and Positive Symptom Distress Index (PSDI; indicating the intensity of distress). Perceived stress was assessed using the 10-item Perceived Stress Scale and Short Form-36 (SF-36) questionnaire.
Researchers studied potential correlations between SCL-90 domains and PCOS-specific parameters, perceived stress, and quality-of-life measures.
TAKEAWAY:
Women with PCOS had a higher BMI and Ferriman Gallwey score; higher levels of testosterone, DHEA-S, LH, prolactin, and AMH; a higher Free Androgen Index; and higher rates of PCOM than control women (P < .05).
After adjustments for age and BMI, women with PCOS had significantly higher SCL-90 scores than control women on seven subscales, including hostility, anxiety, depression, paranoid ideation, psychoticism, somatisation, and interpersonal sensitivity (P < .05), as well as on all three global indices (GSI, PST, and PSDI).
All SCL-90 domains were significantly positively correlated with perceived total stress and perceived helplessness and negatively correlated with perceived self-efficacy (P < .05).
SCL-90 scores were negatively correlated with most SF-36 domains (P < .01), indicating a lower quality of life in women with PCOS than in control women.
IN PRACTICE:
"Women with PCOS experience significantly higher levels of psychological symptoms including depression, anxiety, and elevated perceived stress, compared to women without PCOS. Moreover, our findings reveal that greater perceived stress and feelings of helplessness, along with lower self-efficacy, are strongly linked to increased psychological symptomatology," the authors wrote. "These results underscore the need for intervention programs focused on emotional regulation and stress management and highlights the importance of routine mental health screening in PCOS populations," they added.
SOURCE:
This study was led by Marie-Louise Marschalek, Medical University of Vienna, Vienna, Austria. It was published online on July 18 in the Journal of Clinical Medicine.
LIMITATIONS:
The small sample size and homogenous population analysed in the study may have limited the generalisability of the results. Unknown medical conditions may have existed in the control group, potentially affecting the results. SCL-90/SF-36 were not validated for PCOS.
DISCLOSURES:
This study did not receive any external funding. The authors reported having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.