Polycystic Ovary Syndrome (PCOS) and psychological burden: A Case-Control Study

Abstract

Background: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder prevalent among reproductive-aged
women, characterized by menstrual dysfunction, hyperandrogenism, and metabolic disturbances. It is associated with
increased psychological distress, including depression, anxiety, and stress, which may impact overall quality of life.
Objectives: This study aims to assess psychological distress in PCOS patients compared to matched controls, adjusting
for potential confounders, utilizing a structured case-control design. Methods: A matched case-control study was
conducted with a (9
th
point) Case: Control ratio of 1:2. The study sample comprised 44 PCOS-diagnosed women (aged
18–24 years) based on the Rotterdam criteria and 76 age-matched controls confirmed to be PCOS-free through clinical
assessment and trans-abdominal ultrasonography. Participants were recruited from the Gynecology Outpatient Clinic, Sir
Sunder Lal Hospital, Banaras Hindu University. Psychological distress was assessed using the validated Hindi version of
the Depression, Anxiety, and Stress Scale (DASS-21), with prior permission obtained for its usage. Statistical analysis
included descriptive statistics, chi-square tests, and logistic regression modeling to assess associations between PCOS and
psychological burden. Results: PCOS participants exhibited significantly higher levels of psychological distress compared
to controls. Mean (S.D.) scores for depression (16.2 (4.8) vs. 11.7 (3.6), anxiety (15.7 (4.2) vs. 9.4 (3.1)), and stress (21.3
(5.1) vs. 15.0 (4.0)) were significantly elevated in the PCOS group (p < 0.05). Logistic regression analysis indicated a
twofold increase in depression risk (OR=2.00; 95% CI 0.88, 4.57), a 2.5-fold higher likelihood of anxiety (OR=2.51; 95%
CI 1.02, 6.17), and a 3.6-fold elevated risk of stress (OR=3.62; 95% CI 1.32, 9.86), all statistically significant at p < 0.05.
Conclusion: The findings suggest that PCOS is strongly associated with increased psychological distress. Early
identification and management of psychological symptoms should be integrated into the clinical care of PCOS patients to
enhance their mental well-being.