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.