Abstract Disclosure: J.P. del Rio: None. R. Gonzalo: None. M. Maliqueo: None. B. Echiburu: None. A. Ladron de Guevara: None. P. Gaspar: None. M. Alejandro: None. N.R. Crisosto: None. Introduction: Polycystic Ovarian Syndrome (PCOS) is the most prevalent endocrine disorder in adolescents. PCOS is characterized by hyperandrogenism, which can modulate brain maturation, especially in highly neuronal plasticity periods, such as intra-uterine life and adolescence. Daughters of women with PCOS (dPCOS) will probably be exposed to hyperandrogenism during these two periods. However, the effects of hyperandrogenism on psychosocial development have not yet been fully characterized. Objectives: To characterize the consequences of hyperandrogenism in the emotional status and social cognition (SC) on dPCOS. Methods/Design: Analytical cross-sectional study. dPCOS and controls between 12 to 25 years old were recruited. Participants underwent a complete clinical evaluation, serum hormone determinations (including total testosterone, SHBG, androstenedione, 17-OH-progesterone, and OGTT-I with 4 collections (0’-30’-90’-120´)) and ovarian ultrasound characterization. Emotional status and SC were estimated by measurements of affects (PANAS), strength and difficulties (SDQ), self-reported empathy (EQ/SQ and AQ), and gaze patterns measurement via Eye-Tracking (while completing an emotional recognition task). Results: 33 participants were recruited, 15 cases and 18 controls. Median age was 17 and 18 years, respectively. The dPCOS presented a larger anogenital distance (cm) (9.7 vs 7.8; p=0.014), Ferryman-Gallwey score mean (13.0 vs 2.0; p=<0.001) and free androgen index value (7.5 vs 4.1; p=0.004), suggesting hyperandrogenism exposure during intrauterine and adolescence periods. Regarding emotional status and SC, dPCOS exhibited a predominantly negative affective status (PANAS 8.0 vs 2.0, p=0.049) and a higher score in socio-emotional problems (SDQ 2,5 vs 1,5; p=0,047). The eye-tracking registration showed that dPCOS presented a longer time to first fixation in areas of interest (s) (0,35 vs 0,28; p=0,037), which was associated with a worse endpoint in emotional recognition (aR2=-0,920; f=19,48; Pr >|t|=<0,049). Furthermore, the 2D:4D ratio (intrauterine marker of androgen exposure) and insulin levels at 60’ were correlated with a predominance of negative affects (rho=0,51; p=0,019 and rho= -0,48; p=0,035), and 2D:4D ratio was also correlated with less prosocial behaviors (coef=-2,39; P>|t|=0,049). Conclusions: Clinical and hormonal markers suggest that dPCOS are exposed to hyperandrogenism during the most critical neuroplasticity periods. This exposure is associated with a predominance of negative affects, more social-emotional difficulties and worse performance on emotional recognition and prosocial behavior. Considering PCOS patient’s elevated psychiatric comorbidity, early mental health intervention becomes crucial, underscoring the necessity for in-depth study on hyperandrogenism's impacts on psychosocial development. Presentation: 6/3/2024