Health-related quality of life and psychological distress in polycystic ovary syndrome: a hidden facet in South Asian women

Objective Polycystic ovary syndrome (PCOS) is associated with symptoms that affect psychological wellbeing and health-related quality of life (HRQoL). We wished to assess psychological distress and HRQoL among Sri Lankan women with PCOS. Design Case-control study. Setting Gampaha District, Sri Lanka. Population A total of 146 newly diagnosed women with PCOS, according to the Rotterdam criteria, and 170 age-matched controls recruited from community screening of 3030 eligible women between 15 and 39 years of age. Methods World Health Organization Quality of Life questionnaire (WHOQOL-BREF), validated for Sri Lankans with PCOS and a 30-item General Health Questionnaire (GHQ30) were used to assess HRQoL and psychological distress, respectively. Main outcome measures Assessment of psychological distress, HRQoL and their correlates. Results The mean GHQ score was significantly higher (P < 0.001) among women with PCOS (5.25 +/- 6.25 SD) than among controls (1.58 +/- 1.46 SD), indicating greater psychological distress. Hirsutism in PCOS (defined as a Ferriman-Gallwey, FG, score >= 8) was significantly associated with psychological distress (P = 0.002). Multivariate analysis revealed the FG score as a significant predictor of psychological distress (P < 0.05). Mean scores for the physical, psychological and social relationships domains of the WHOQOL-BREF were significantly lower (P = 0.01) in women with PCOS than in controls, indicating poorer HRQoL. No significant predictors of HRQoL emerged from the multivariate analysis. Women with PCOS did not perceive excess body weight as a factor affecting their psychological wellbeing and HRQoL. Conclusions PCOS occurring in South Asians adversely affects their psychological wellbeing and HRQoL. Their psychological distress is related to hirsutism rather than to obesity, which affects white Europeans with PCOS.