Associations Between Psychologic Symptoms and Life Satisfaction in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is associated with many physical and physiological changes and can affect women's psychological functioning and satisfaction with life. Previous research has focused mainly on cardiovascular risk factors, with few studies investigating the psychological effects of the condition. The aims of this study were (1) to determine if clinically depressive symptoms and psychological traits (anger, anxiety, hostility/cynicism) and decreased satisfaction with life are associated with PCOS; (2) to investigate within PCOS cases, factors associated with depressive symptoms, specifically body mass index (BMI), smoking status, education, marital status, and parity. Design: The subjects examined in this study were selected from those in a previous case-control study, with observational follow-up over a 12-year period, 1995 to 2006. Methods: A total of 161 cases and 161 controls were matched on age, race, and neighborhood and participated in the baseline psychological assessment arm of our original study. They were part of the original Cardiovascular Health and Risk Measurement Study conducted in 1992-1994 to investigate coronary heart disease risk factors in women with PCOS. Psychological characteristics of the women were assessed using the Beck Depression Inventory I (BDI I), the Spielberger Trait Anger and Anxiety Scales, the Cook-Medley Scale, and the Diener Satisfaction with Life Scale. Results: Women with PCOS had a higher prevalence of mild or moderate depressive symptom levels (BDI scores >9): 31% vs. 17% in controls (p = 0.016; OR 1.9, CI 1.55-2.16). The difference between cases and controls for the continuous BDI score was also statistically significant (p = 0.002). The odds of having PCOS increased with each unit of BDI score by 1.06. Within cases, results of the logistic regression analysis showed that BMI, education, and parity were significant predictors of mild or moderate depressive symptoms (p < 0.05). The odds of a BDI score >9 increased by 6% for each unit increase of BMI and by 44% for parity (per live birth), and decreased by 20% for each year of education. The associations between PCOS and anger, hostility, hostility/cynicism, and satisfaction with life were not significant. Conclusions: Depressive symptoms are a significant psychological concern in PCOS. Among women with PCOS, those who are heavier and have more children and less education are at greatest risk for mild to moderate depressive symptoms. Women should be screened at regular intervals in order to detect risk factors for depression and to treat depressive symptomatology.