Psychosocial Predictors of Anxiety and Depression in Women with Polycystic Ovary Syndrome: A Cross- Sectional Study

Abstract

Background: Women with polycystic ovary syndrome (PCOS) frequently experience psychological distress, including anxiety and depression. However, few studies in low- and middle-income countries have examined psychosocial predictors, particularly using symptom-specific quality-of-life instruments.
Objective: To assess the influence of patient activation, body image dissatisfaction, and perceived social support on anxiety and depression in women with PCOS, and to evaluate symptom-specific associations using the Modified PCOS Questionnaire (M-PCOSQ).
Methods: In this cross-sectional study conducted at a tertiary care hospital in India, 100 women diagnosed with PCOS according to Rotterdam criteria were assessed. Participants completed the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Patient Activation Measure (PAM-13), the Modified Body Image Scale, and the M-PCOSQ. Correlation and multiple linear regression analyses were performed.
Results: Clinical anxiety and depression were observed in 61% and 42% of participants, respectively. Poor social support significantly predicted both anxiety (beta= -0.592, p < 0.001) and depression (beta = -0.313, p = 0.004). Body image dissatisfaction was associated with depression (beta = 0.286, p = 0.011), and low patient activation was linked to anxiety (beta = 0.286, p = 0.005). Among M-PCOSQ domains, menstrual irregularities and infertility concerns were most strongly associated with anxiety (r = 0.730 and r = 0.800, respectively), while emotional disturbances correlated with depression (r = 0.340, p = 0.040). Regression models explained 36.6% and 39.9% of variance in depression and anxiety, respectively.
Conclusion: In women with PCOS, low social support, poor patient activation, and body image dissatisfaction significantly contribute to psychological morbidity. Symptom-specific concerns such as menstrual irregularities, infertility, and emotional symptoms are critical in identifying at-risk individuals. Routine mental health screening and psychosocial interventions should be integral to PCOS management.