Prevalence of depression, anxiety and Quality of life among North Indian Polycystic ovary syndrome Women: Evidence from a prospective observational study
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20214500Keywords:
PCOS, Anxiety, Depression, QOLAbstract
Background: Polycystic ovary syndrome (PCOS) is a common heterogeneous gynaecological endocrine disorder characterized by clinical features including oligo-amenorrhea/ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. PCOS increases the risk of depression and anxiety which leads to poor quality of life. Aim of the study were to determine the prevalence of anxiety and depression among women suffering from PCOS and to determine the quality of life (QOL) in PCOS women.
Methods: The study was prospective, observational, non-interventional and questionnaire-based. 192 women with PCOS voluntarily helped in filling the questionnaires consisting of questions using PHQ-9 for depression, GAD-7 for anxiety, SF-12 for general health and PCOSQ-50 for disease-specific domains. All data were recorded in pre-designed case record forms and analysis of data was done using different statistical methods.
Results: Majority of PCOS women were either overweight or obese. Based on PHQ-9 20% of women was suffering with major depression and based on GAD-7, 25% with major anxiety. It is found that psychosocial and emotional domain and coping domain of PCOSQ-50 is significant in patients with major depression and major anxiety. Significant effects were seen on their general health as per SF-12 domain. Lack of physical exercise was found in 83% of women.
Conclusions: PCOS is a complex disease which decreases the overall quality of life. Therefore, treatment of PCOS women should include psychological counselling along-with with medication, especially in obese PCOS women. Women should be educated with the benefits of lifestyle modification in PCOS.
References
Azziz R, Woods KS, Reyna R, Key TJ. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89(6):2745-9.
Ehrmann DA. Polycystic ovary syndrome. N Eng J Med. 2005;352(12):1223-36.
Sulaiman MA, Al-Farsi YM, Al-Khaduri MM. Psychological burden among women with polycystic ovarian syndrome in Oman: a case-control study. In j women's health. 2017;9:897.
Malik‐Aslam A, Reaney MD, Speight J. The Suitability of Polycystic Ovary Syndrome‐Specific Questionnaires for Measuring the Impact of PCOS on Quality of Life in Clinical Trials. Value in health, 2010;13(4):440-6.
Sonia M, Jain K, Talwar P, Prasad S, Dhorepatil B. Management of polycystic ovary syndrome in India. Fertility Sci Res. 2014;1:23.
Anuja D, Bochner M, Hollinrake E, Markham S, Van Voorhis B. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstetri Gynecol. 2005;106(1):131-7.
Richard LS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J clin endocrinol metab. 1999;84(1):165-9.
Jan H, Bergh T, Berne C, Lithell H. Serum lipoprotein lipid profile in women with the polycystic ovary syndrome: relation to anthropometric, endocrine and metabolic variables. Clin endocrinol. 1994;41(1):463-71.
Michael S, Kong C, Patel A, Unwin R, Jacobs HS. Ambulatory blood pressure profiles and plasminogen activator inhibitor (PAI‐1) activity in lean women with and without the polycystic ovary syndrome. Clin endocrinol. 1996;45(5):623-9.
Kalpana L, Seifalian AM, Hardiman P. Impaired carotid viscoelastic properties in women with polycystic ovaries. Circulation. 2002;106(1):81-5.
Mattias M, Holte J, Landin-Wilhelmsen K, Dahlgren E, Johansson A. Women with polycystic ovary syndrome are often depressed or anxious-a case control study. Psychoneuroendocrinology. 2008;33(8):1132-8.
Helena V, Svanberg AS, Ekselius L, Lundkvist O, Poromaa IS. Prevalence of psychiatric disorders in infertile women and men undergoing in vitro fertilization treatment. Human Reproduction. 2008;23(9):2056-63.
Barnard L, Ferriday D, Guenther N, Strauss B, Balen AH, Dye L. Quality of life and psychological well being in polycystic ovary syndrome. Human reproduction. 2007;22(8):2279-86.
Upadhyaya, Kumar S, Sharma A, Agrawal A. Prevalence of anxiety and depression in polycystic ovarian syndrome. Int J Med Sci Public Health. 2016;5(4):681-3.
Arshad H, Chandel RK, M. Ashraf G, Dar MA, Rather YH. Prevalence of psychiatric disorders in patients with a diagnosis of polycystic ovary syndrome in Kashmir. Indian j psychol med. 2015;37(1):66-70.
Fauser, Bart CJM, Tarlatzis BC, Rebar RW, Legro RS, Balen AH et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertility sterility. 2012;97(1):28-38.
Ndefo, Anadu U, Eaton A, Green MR. Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. Pharmacy therapeutics. 2013;38(6):336.
Escobar-Morreale, Hector F. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nature Reviews Endocrinol. 2018;14(5):270-84.
ESHRE, The Rotterdam, and ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility sterility. 2004;81(1):19-25.
Association WM, World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organization. 2001;79(4):373.
Hahn, Susanne, Janssen OE, Tan S, Pleger K, Mann K et al. Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome. Eur J Endocrinol. 2005;153(6):853-60.
Kumarapeli V, De Seneviratne RA, Wijeyaratne CN, Yapa RM, Dodampahala SH. A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semiurban population in Sri Lanka. Am j epidemiol. 2008;168(3):321-8.
Blay, Luis S, Aguiar JVA, Passos IC. Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis. Neuropsychiatric disease treatment. 2016;12:2895.
Bhattacharya, Mohan S, Jha A. Prevalence and risk of depressive disorders in women with polycystic ovary syndrome (PCOS). Fertility sterility. 2010;94(1):357-9.
Balen, Adam H, Morley LC, Misso M, Franks S. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Human reproduction update. 2016;22(6):687-708.
Veltman-Verhulst, Susanne M, Boivin J, Eijkemans MJC, Fauser BJC. Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies. Human reproduction update. 2012;18(6):638-51.
Deeks AA, Gibson-Helm ME, Paul E, Teede HJ. Is having polycystic ovary syndrome a predictor of poor psychological function including anxiety and depression? Human Reproduction. 2011;26(6):1399-407.
Balen, Adam H, Conway GS, Kaltsas G, Techatraisak K, Manning PJ et al. Andrology: Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Human reproduction. 1995;10(8):2107-11.
Stapinska-Syniec A, Grabowska K, Szpotanska-Sikorska M, Pietrzak B. Depression, sexual satisfaction, and other psychological issues in women with polycystic ovary syndrome. Gynecol Endocrinol. 2018;34(7):597-600.
Maria E, Wijma K, Benzein E. “It is always on my mind”: Women's experiences of their bodies when living with hirsutism. Health care for women int. 2009;30(5):358-72.
Ioannis ME, Messini CI, Anifandis G, Dafopoulos K. Polycystic ovaries and obesity. Best Practice Res Clin Obstetr Gynaecol. 2015;29(4):479-88.
Siew L, Smith CA, Costello MF, MacMillan F, Moran L. Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: a qualitative study. BMC endocrine disorders. 2019;19(1):1-9.
Michael J, Fatehi F, Phillips-Chan ME, Richardson JR. Exploratory study of a screening measure for polycystic ovarian syndrome, quality of life assessment, and neuropsychological evaluation. BMC Women's Health. 2020;20(1):1-12.