Objective: Polycystic ovary syndrome (PCOS) has been shown to cause a reduction in quality of life. This study examines the extent of different PCOS symptoms on quality-of-life, psychosocial well-being and sexual satisfaction. Methods: Complete metabolic, hormonal, clinical and psychosocial data were obtained from a total of 120 women with PCOS. Patients were compared with 50 healthy women to establish reductions in quality-of-life and emotional well-being. In addition, the correlation between psychosocial variables and the major clinical PCOS features obesity (body mass index (BMI)), excessive body hair (hirsutism score), acne, hyperandrogenism (serum testosterone levels), disturbed insulin regulation (area under the insulin response curve and homeostasis model assessment of insulin resistance), menstrual cycle disturbances and infertility were analyzed. Results: PCOS patients showed significant reductions in quality-of-life, increased psychological disturbances, and decreased sexual satisfaction when compared with healthy controls. BMI and hirsutism scores, but not the presence of acne, were associated with physical aspects of quality-of-life and sexual satisfaction. No clear effect of androgens or insulin resistance on psychosocial variables was detected. Similarly, the type of menstrual cycle disturbances or infertility had no impact on psychological well-being. Conclusion: In PCOS, changes in appearance, particularly obesity and hirsutism, reduce physical dimensions of quality-of-life and decrease sexual satisfaction. The role of biochemical, endocrine and metabolic parameters as well as menstrual irregularities and infertility appeared to be less important. Clinicians should pay attention to the psychosocial dimensions of PCOS on an individual basis, regardless of symptom severity or treatment response.

BACKGROUND: The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes. METHODS: Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support. RESULTS: Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 ± 2.81 cm with low support versus 51.76 ± 2.31 cm with high support) and birthweight (F = 11.35, P = 0.001; 3175 ± 453 g with low support versus 3571 ± 409 g with high support). In smokers, pregnancy complications occurred more frequently when given low support {34 versus 10.3% with high support, χ² = 5.49, P = 0.019; relative risk (RR) = 3.3 [95% confidence interval (95% CI) = 1.1–10.2]}, and the proportion of preterm deliveries was greater given low support (10.0 versus 0% with high support, χ² = 3.84, P = 0.05, odds ratio = 8.1). CONCLUSIONS: Lack of social support constitutes an important risk factor for maternal well-being during pregnancy and has adverse effects on pregnancy outcomes.

Comparatively little attention has been paid to the symptoms of anxiety in polycystic ovary syndrome (PCOS), although anxiety disorders constitute the most common psychiatric diagnoses among endocrine patients and in the general population. Therefore, our goal was to address the prevalence, determinants and implications of anxiety alone or anxiety in combination with depression in German women with PCOS. In this nation-wide, internet-based survey, anxiety and depression (Hospital Anxiety and Depression Scale, HADS) and quality of life (SF-12) were assessed together with sociodemographic information and clinical PCOS symptoms in 448 PCOS women. Of the patients, 34% showed clinically relevant HADS anxiety scores and 21% had clinically relevant HADS depression scores. Quality of life was significantly impaired in PCOS women with anxiety (P < 0.001), in particular, in women with comorbid anxiety and depression (P < 0.001). The risk for clinically relevant HADS anxiety scores was significantly enhanced in PCOS women with acne (odds ratio (OR) = 1.52; 95% confidence interval (CI) = 1.03–2.52) and an unfulfilled wish to conceive (OR = 1.50; 95% CI = 1.01–2.23). PCOS women may be at an increased risk for clinically relevant anxiety, and comorbid anxiety and depression is also very common. Anxiety contributes to impaired quality of life in PCOS. Given the high prevalence and the serious implications, and the availability of effective treatment options given proper diagnosis, clinicians should be more aware of anxiety disorders in women with PCOS.

BACKGROUND: The goals were to analyse the incidence of mental distress in women with untreated polycystic ovary syndrome (PCOS) using self-report measures, to characterize PCOS patients at risk for psychiatric disease with regard to sociodemographic and clinical characteristics, and to assess the impact of emotional distress on quality of life. METHODS AND RESULTS: Complete metabolic, hormonal, clinical and self-report psychological data [emotional distress, Symptom Check List 90 (SCL-90-R); quality of life, Short-Form Health Survey 36 (SF-36); sexual satisfaction, visual analogue scales; sociodemographic data] were obtained from n = 143 untreated women with PCOS. Prior psychiatric diagnoses were exclusionary. Twenty-two patients (15.4%) had a possible psychological disorder, based on SCL-90-R global severity index (GSI) scores ≥63 (SCL cases). SCL cases had significantly elevated body mass index (BMI), but did not differ from SCL non-cases in other clinical, endocrine, metabolic or sociodemographic variables. Stepwise multiple regression analyses identified GSI as a significant predictor of SF-36 Psychological Sum score, along with age and current wish to conceive (R² = 0.47); the SF-36 Physical Sum score was predicted by BMI and education (R² = 0.27), but not GSI. CONCLUSIONS: Psychiatric illness may go undetected in a proportion of PCOS patients. Although the majority of patients exhibit subclinical levels of psychological disturbances, emotional distress together with obesity lead to large decrements in quality of life in PCOS.