P-471 Anxiety, depression, and body image among infertile women with and without polycystic ovary syndrome

Abstract

Abstract Study question Do women with PCOS undergoing fertility treatment experience higher anxiety and depression symptoms, along with lower body appreciation, compared to those without PCOS? Summary answer Having PCOS was not associated with symptoms of anxiety and depression, but was associated with somewhat lower body appreciation. What is known already PCOS has been associated with a higher chance to develop mental health problems, like anxiety, and body image concerns. The International Guidelines on PCOS recommend that all women with PCOS should routinely be screened for anxiety and depressive disorders. In most studies in this field, the comparison group included healthy women without fertility problems. Study design, size, duration We conducted a cross-sectional survey study between May 2021 and July 2023, using an online questionnaire. We informed women about this study at fertility clinics in the Netherlands through posters and leaflets and on the websites of the Dutch patient organizations Freya and Stichting PCOS. Participants/materials, setting, methods This study included women with infertility, with and without PCOS, undergoing fertility treatment. Women completed the Hospital Anxiety and Depression Scale and the Body Appreciation Scale-2. Primary outcomes were clinically relevant symptoms of anxiety and depression (scores>11), and BAS-2 scores. Secondary outcomes were mean anxiety and depression scores, along with scores of 8 and higher. Dichotomous and continuous outcomes were analysed using logistic and linear regression analyses adjusted for age, BMI, and duration of infertility. Main results and the role of chance A total of 1025 women currently undergoing infertility treatment participated, of whom 502 (49.0%) had PCOS and 523 (51.0%) had other infertility diagnoses. We found self-reported clinically relevant symptoms of anxiety in 33.1% of women with PCOS and in 31.0% of women with other infertility diagnoses (adjusted OR: 0.99, 95% CI 0.74 – 1.31). Clinically relevant symptoms of depression were reported in 15.5% of women with PCOS versus 14.5% of women with other infertility diagnoses (adjusted OR: 1.04, 95% CI 0.71 – 1.50). Women with PCOS reported slightly less body appreciation (adjusted mean difference: -1.34, 95% CI -2.32 to -0.36). Limitations, reasons for caution Results are based on self-report and may have been affected by sampling bias. Wider implications of the findings Although guidelines recommend screening women with PCOS, feelings of anxiety and depression can be present in any woman undergoing fertility treatments. We advise fertility clinics to be aware of women’s mental health issues and to offer support accordingly, as a part of routine care. Trial registration number not applicable