Differential Contributions of the Reproductive and Metabolic Features of Polycystic Ovary Syndrome (PCOS) to Psychological Symptoms

Objective: Although women with PCOS have elevated levels of psychological distress, findings regarding which aspects of PCOS contribute to psychological symptoms are inconsistent. The purpose of this study was to investigate the independent and differential contributions of the previously identified key PCOS manifestations (infertility, hirsutism, obesity, menstrual problems) to multiple psychological symptoms. Methods: Participants were 126 endocrinology patient volunteers diagnosed with PCOS who completed a cross-sectional study of key manifestations of PCOS (including the PCOSQ) and psychological symptoms (BSI). Results: Participants had significantly elevated scores on all nine BSI subscales of psychological symptoms. Menstrual problems were significantly associated with all symptom subscales as well as the global indicator, while hirsutism and obesity were significantly related to five or more subscales. Neither infertility status nor infertility concerns significantly predicted any of the psychological symptoms. After controlling for demographic factors, menstrual problems remained the strongest predictor of psychological symptoms. Conclusions: Findings suggest that for women with PCOS, the features of excess body hair, obesity and menstrual abnormalities are especially troubling and carry unique risks for serious adverse psychologic symptoms including depression, anxiety, somatization and interpersonal sensitivity. Specific manifestations of PCOS were differentially related to psychological symptoms suggesting that the predictive value of PCOS for depression and other mental health problems may vary according to the specific symptoms experienced. Menstrual problems may be the most salient of these features and deserve particular attention as a marker for psychological risk among women with PCOS.