Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive aged women. The prevalence of comorbidities associated with PCOS vary with phenotype and race. An increased risk of moderate and severe depressive and anxiety symptoms has been reported in this group. Racial differences in prevalence of mood disorders described in the general population are influenced by factors such as obesity and socioeconomic status (SES). We aimed to determine the prevalence of depression, anxiety and decreased quality of life between black and white women with PCOS and controls. We screened women (18-50 years) at an academic center from November 2015-18 using the Hospital Anxiety and Depression Scale (HADS) and PCOS quality of life survey (PCOSQ). Multivariable regression models were used to evaluate racial differences in the prevalence of depression and anxiety (HADS≥8) and mean scores for depression, anxiety and PCOSQ. Correlations between FG score, testosterone, BMI, HOMA-IR and depression, anxiety and PCOSQ scores were analyzed. Overall women with PCOS (n=272) had a higher prevalence of depressive (26% vs 17%, p<0.01) and anxiety symptoms (72% vs 52%, p<0.01) compared to controls (n=295) after adjusting for age, BMI, SES and race. Compared to black women with PCOS (n=70), white women with PCOS (n=202) had a higher prevalence of anxiety symptoms (76% vs 61%, p=0.01) and scores (10.3 +4.1 vs 8.7 +4.6, p=0.01) after adjusting for age, BMI and SES. BMI correlated with anxiety scores in white but not black women with PCOS (p<0.01). There were no racial differences in the prevalence of depressive symptoms (p=0.8) or mean scores (p=0.4). In the control group, white women (n=186) had a higher prevalence for anxiety symptoms (60% vs 47%, p=0.04) not depressive symptoms (13 % vs 18%, p=0.7) compared to black women (n=109). There were no significant differences in mean anxiety or depression scores in the controls. There were no racial differences in global PCOSQ score (110.7 +30 for white women vs 98.6 +36.1 for black women, p=0.6). On examining the individual domains of the PCOSQ, black women scored lower than white women on the emotion and infertility domain (p<0.01). There were no racial differences in the correlation between FG score, testosterone, HOMA-IR and anxiety, depression and total PCOSQ scores. This study is the first to examine racial differences in anxiety and depressive symptoms in PCOS. White women with PCOS had significantly higher anxiety symptoms compared to black women and BMI positively correlated with these symptoms. Black women however have lower scores in several PCOSQ domains indicating lower quality of life. Despite racial differences in anxiety symptoms, our study confirms the need to screen both races for anxiety and depressive symptoms given their high prevalence. Targeted interventions such as weight management may help mitigate some of these symptoms.
Published Version
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