Research Article
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Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome?

Year 2021, Volume: 74 Issue: 1, 38 - 42, 30.04.2021

Abstract

Objectives: Polycystic ovary syndrome (PCOS) is the most prevalent female reproductive disorder. PCOS is associated with increased mood disorders. We aimed to evaluate the association between PCOS sub-phenotypes and anxiety, body perception, and depression scales in our study.

Materials and Methods: We enrolled 74 patients with PCOS and we assigned them into subphenotypes of PCOS. The Beck depression inventory (BDI-II) was used for depression, the Beck anxiety inventory (BAI) was used for anxiety, and the body esteem scale (BES) was used to assess body perception for all participants.

Results: The BDI-II scores of phenotype A were higher than phenotype D. The BAI scores of phenotype A were higher than phenotype B, C, and D. There was no difference between BES scores through all PCOS phenotypes. There was a difference in modified Ferriman-Gallwey score between phenotypes except between phenotype A and phenotype B (p=0.13). An increase in BMI by 1 kg/m2 was found to cause a 0.49 increase in depression scores (p=0.01) but there was no association between BMI and BAI and BES scores (p=0.33, p=0.18).

Conclusion: PCOS is associated with mood disorders, especially anxiety and depression. Until now, there was no information about the prevalence of mood disturbances according to subphenotypes of PCOS. The higher prevalence of depression was seen in phenotype A than phenotype D but it was similar among A, B, and C. It has suggested that hyperandrogenism may have a causative effect on pathogenesis of depression in women with PCOS. The higher BAI scores were recorded in phenotype A than phenotype B, C, and D, and BES scores were similar through phenotypes. Although we could not find a close phenotype-mood disorder association, we believe the need for screening for mood disorders, especially anxiety and depression, for patients with PCOS because of the importance of the disease’s psychological consequences.

Key Words: PCOS Phenotypes, Depression, Anxiety, Body Perception, Modified Ferriman-Gallwey Score

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References

  • 1. Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Frontiers in bioscience. 2014;6:104-119.
  • 2. Yildiz BO, Bozdag G, Yapici Z, et al. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Human reproduction. 2012;27:3067-3073.
  • 3. Wolf WM, Wattick RA, Kinkade ON, et al. Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. International journal of environmental research and public health 2018;15.
  • 4. Lizneva D, Suturina L, Walker W, et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertility and sterility. 2016;106:6-15.
  • 5. Jedel E, Waern M, Gustafson D et al. Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index. Human reproduction. 2010;25:450-456.
  • 6. Neven ACH, Laven J, Teede HJ, Boyle JA. A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines. Seminars in reproductive medicine. 2018;36:5-12.
  • 7. Veltman-Verhulst SM, Boivin J, Eijkemans MJ, et al. Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies. Human reproduction update. 2012;18:638-651.
  • 8. The Rotterdam ESHRE/ASRM‐sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human reproduction. 2004;19:41-47.
  • 9. Ferriman D, Purdie AW. The aetiology of oligomenorrhoea and/or hirsuties: a study of 467 patients. Postgraduate medical journal. 1983;59:17-20.
  • 10. Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. Journal of personality assessment. 1996;67:588-597.
  • 11. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893-897.
  • 12. Franzoi SL, Shields SA. The Body Esteem Scale: multidimensional structure and sex differences in a college population. Journal of personality assessment 1984;48:173-178.
  • 13. Lizneva D, Kirubakaran R, Mykhalchenko K et al. Phenotypes and body mass in women with polycystic ovary syndrome identified in referral versus unselected populations: systematic review and meta-analysis. Fertil Steril. 2016;106:1510-1520 e2.
  • 14. Carmina E, Chu MC, Longo RA, et al. Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters. J Clin Endocrinol Metab. 2005;90:2545-2549.
  • 15. Sanchez-Garrido MA, Tena-Sempere M. Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Molecular metabolism. 2020;35:100937.
  • 16. Cooney LG, Lee I, Sammel MD, et al. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction. 2017;32:1075-1091.
  • 17. Wild RA, Carmina E, Diamanti-Kandarakis E et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010;95:2038-2049.
  • 18. Weiner CL, Primeau M, Ehrmann DA. Androgens and mood dysfunction in women: comparison of women with polycystic ovarian syndrome to healthy controls. Psychosom Med. 2004;66:356-362.
  • 19. Yu Q, Hao S, Wang H, et al. Depression-Like Behavior in a Dehydroepiandrosterone-Induced Mouse Model of Polycystic Ovary Syndrome. Biol Reprod. 2016;95:79.
  • 20. Benson J, Severn C, Hudnut-Beumler J et al. Depression in Girls With Obesity and Polycystic Ovary Syndrome and/or Type 2 Diabetes. Can J Diabetes. 2020;44:507-513.
  • 21. Kolotkin RL, Binks M, Crosby RD, et al. Obesity and sexual quality of life. Obesity. 2006;14:472-479.

Polikistik Over Sendrom Fenotipleri Arasında Depresyon, Anksiyete ve Beden Algısı Ölçekleri Açısından Farklılık Var Mıdır?

Year 2021, Volume: 74 Issue: 1, 38 - 42, 30.04.2021

Abstract

Amaç: Polikistik over sendromu (PKOS), en yaygın kadın üreme bozukluğudur. PKOS duygudurum bozuklukları ile ilişkilidir. Çalışmamızda PKOS alt fenotipleri ile anksiyete, beden algısı ve depresyon ölçekleri arasındaki ilişkiyi değerlendirmeyi amaçladık.

Gereç ve Yöntem: Çalışmaya PKOS’li 74 hasta dahil edilmiş ve PKOS’nin alt fenotiplerine ayrılmıştır. Tüm katılımcılara depresyon için Beck depresyon envanteri (BDI-II), anksiyete için Beck anksiyete envanteri (BAE) ve beden algısını değerlendirmek için beden saygısı ölçeği (BES) kullanıldı.

Bulgular: Fenotip A’nın BDI-II skorları, fenotip D’den daha yüksekti. Fenotip A’nın BAI skorları, fenotip B,C ve D’den yüksekti. BES skorları açısından tüm fenotipler açısından fark yoktu. Fenotip A ve fenotip B dışında (p=0,13), fenotipler arasında Ferriman-Gallway skorları açısından fark yoktu. BKİ’deki her 1 kg/m2 artışın, depresyon skorlarında 0,49 artışa neden olduğu, ancak BKİ, BAI ve BES skorları arasında ilişki bulunmadığı tespit edildi (p=0,33, p=0,18).

Sonuç: PKOS duygudurum bozuklukları ile ve özellikle anksiyete ve depresyon ile ilişkilidir. Şimdiye kadar, PKOS alt fenotiplerine göre duygudurum bozukluklarının yaygınlığı hakkında bilgi bulunmamaktadır. Fenotip A’da, fenotip D’ye göre daha yüksek depresyon prevalansı görülmüş, ancak A, B ve C arasında benzerlik görülmüştür. Bu durum, PKOS’li kadınlarda hiperandrojenizmin depresyon patogenezinde nedensel bir etkiye sahip olabileceğini düşündürmüştür. Fenotip A’da, fenotip B, C ve D’ye oranla daha yüksek BAI skorları tespit edilmiş, ancak BES skorları tüm gruplarda benzer bulunmuştur. Fenotip-duygudurum bozukluğu ilişkisi özgül olarak bulunamamış olsa da, hastalığın psikolojik sonuçlarının önemi nedeniyle PKOS’li hastalarda duygudurum bozukluklarının, özellikle anksiyete ve depresyonun taranması gerektiğine inanıyoruz.

Anahtar Kelimeler: PKOS Alt Fenotipleri, Depresyon, Anksiyete, Beden Algısı, Modifiye Ferriman Gallway Skoru

Ethical Statement

Ethics Committee Approval: This study was approved by Ankara University Faculty of Medicine Undergraduate Student Research Ethics Review Board (date: 25.12.2018, decision no: 9530). Informed Consent: All subjects signed informed consent forms. Peer-review: Externally and internally peer-reviewed. Authorship Contributions Surgical and Medical Practices: T.A.E., Concept: D.Ç., Design: Ö.D., Data Collection or Processing: M.S.S., B.Y., Z.T., Ş.N.Y., E.O., E.G., H.H.Ş., Analysis or Interpretation: M.S.S., B.Y., Z.T., Ş.N.Y., E.O., E.G., H.H.Ş., Literature Search: A.G.C., Writing: A.G.C. Conflict of Interest: No conflict of interest was declared by the authors. Financial Disclosure: The authors declared that this study received no financial support.

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Frontiers in bioscience. 2014;6:104-119.
  • 2. Yildiz BO, Bozdag G, Yapici Z, et al. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Human reproduction. 2012;27:3067-3073.
  • 3. Wolf WM, Wattick RA, Kinkade ON, et al. Geographical Prevalence of Polycystic Ovary Syndrome as Determined by Region and Race/Ethnicity. International journal of environmental research and public health 2018;15.
  • 4. Lizneva D, Suturina L, Walker W, et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertility and sterility. 2016;106:6-15.
  • 5. Jedel E, Waern M, Gustafson D et al. Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index. Human reproduction. 2010;25:450-456.
  • 6. Neven ACH, Laven J, Teede HJ, Boyle JA. A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines. Seminars in reproductive medicine. 2018;36:5-12.
  • 7. Veltman-Verhulst SM, Boivin J, Eijkemans MJ, et al. Emotional distress is a common risk in women with polycystic ovary syndrome: a systematic review and meta-analysis of 28 studies. Human reproduction update. 2012;18:638-651.
  • 8. The Rotterdam ESHRE/ASRM‐sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human reproduction. 2004;19:41-47.
  • 9. Ferriman D, Purdie AW. The aetiology of oligomenorrhoea and/or hirsuties: a study of 467 patients. Postgraduate medical journal. 1983;59:17-20.
  • 10. Beck AT, Steer RA, Ball R, Ranieri W. Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. Journal of personality assessment. 1996;67:588-597.
  • 11. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893-897.
  • 12. Franzoi SL, Shields SA. The Body Esteem Scale: multidimensional structure and sex differences in a college population. Journal of personality assessment 1984;48:173-178.
  • 13. Lizneva D, Kirubakaran R, Mykhalchenko K et al. Phenotypes and body mass in women with polycystic ovary syndrome identified in referral versus unselected populations: systematic review and meta-analysis. Fertil Steril. 2016;106:1510-1520 e2.
  • 14. Carmina E, Chu MC, Longo RA, et al. Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters. J Clin Endocrinol Metab. 2005;90:2545-2549.
  • 15. Sanchez-Garrido MA, Tena-Sempere M. Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Molecular metabolism. 2020;35:100937.
  • 16. Cooney LG, Lee I, Sammel MD, et al. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Human reproduction. 2017;32:1075-1091.
  • 17. Wild RA, Carmina E, Diamanti-Kandarakis E et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010;95:2038-2049.
  • 18. Weiner CL, Primeau M, Ehrmann DA. Androgens and mood dysfunction in women: comparison of women with polycystic ovarian syndrome to healthy controls. Psychosom Med. 2004;66:356-362.
  • 19. Yu Q, Hao S, Wang H, et al. Depression-Like Behavior in a Dehydroepiandrosterone-Induced Mouse Model of Polycystic Ovary Syndrome. Biol Reprod. 2016;95:79.
  • 20. Benson J, Severn C, Hudnut-Beumler J et al. Depression in Girls With Obesity and Polycystic Ovary Syndrome and/or Type 2 Diabetes. Can J Diabetes. 2020;44:507-513.
  • 21. Kolotkin RL, Binks M, Crosby RD, et al. Obesity and sexual quality of life. Obesity. 2006;14:472-479.
There are 21 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Research Article
Authors

Asena Gökçay Canpolat 0000-0003-1186-2960

Özgür Demir 0000-0002-9450-3906

Merve Sema Sert This is me 0000-0001-9016-6036

Betül Yarsan This is me 0000-0003-3182-9690

Züleyha Tekfidan This is me 0000-0003-4090-6475

Şeyma Nur Yaman This is me 0000-0003-2999-8532

Esmanur Oğuz This is me 0000-0001-6321-6894

Ela Gazal This is me 0000-0002-6368-4804

Hande Hatice Şimşek This is me 0000-0003-4152-2553

Tuğba Altun Ensari 0000-0002-7819-5325

Demet Çorapçıoğlu 0000-0003-0940-9147

Project Number -
Publication Date April 30, 2021
Published in Issue Year 2021 Volume: 74 Issue: 1

Cite

APA Canpolat, A. G., Demir, Ö., Sert, M. S., … Yarsan, B. (2021). Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome? Ankara Üniversitesi Tıp Fakültesi Mecmuası, 74(1), 38-42. https://doi.org/10.4274/atfm.galenos.2021.52244
AMA Canpolat AG, Demir Ö, Sert MS, et al. Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome? Ankara Üniversitesi Tıp Fakültesi Mecmuası. April 2021;74(1):38-42. doi:10.4274/atfm.galenos.2021.52244
Chicago Canpolat, Asena Gökçay, Özgür Demir, Merve Sema Sert, Betül Yarsan, Züleyha Tekfidan, Şeyma Nur Yaman, Esmanur Oğuz, et al. “Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74, no. 1 (April 2021): 38-42. https://doi.org/10.4274/atfm.galenos.2021.52244.
EndNote Canpolat AG, Demir Ö, Sert MS, Yarsan B, Tekfidan Z, Yaman ŞN, Oğuz E, Gazal E, Şimşek HH, Altun Ensari T, Çorapçıoğlu D (April 1, 2021) Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome? Ankara Üniversitesi Tıp Fakültesi Mecmuası 74 1 38–42.
IEEE A. G. Canpolat et al., “Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome?”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, pp. 38–42, 2021, doi: 10.4274/atfm.galenos.2021.52244.
ISNAD Canpolat, Asena Gökçay et al. “Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74/1 (April2021), 38-42. https://doi.org/10.4274/atfm.galenos.2021.52244.
JAMA Canpolat AG, Demir Ö, Sert MS, Yarsan B, Tekfidan Z, Yaman ŞN, Oğuz E, Gazal E, Şimşek HH, Altun Ensari T, Çorapçıoğlu D. Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome? Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74:38–42.
MLA Canpolat, Asena Gökçay et al. “Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, 2021, pp. 38-42, doi:10.4274/atfm.galenos.2021.52244.
Vancouver Canpolat AG, Demir Ö, Sert MS, Yarsan B, Tekfidan Z, Yaman ŞN, et al. Is There a Difference in Anxiety, Body Perception, and Depression Scales According to Subphenotypes of Polycystic Ovary Syndrome? Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74(1):38-42.