Although physical symptoms of polycystic ovary syndrome (PCOS) are increasingly recognized by practising clinicians, little attention has been focused on psychological correlates of this frequent endocrine disorder.
The review of the medical and psychological literature indicates that PCOS is associated with several mental health problems, including:
- depression
- anxiety
- body dissatisfaction
- eating disorders
- diminished sexual satisfaction
- lower health-related quality of life.
Although the causal direction of these relationships has not been established, it is clear that effective and comprehensive treatment of women with PCOS must encompass careful attention to psychological symptomatology. Potential mechanisms for these associations may include social, psychological, and neurobiological aspects.
Women with PCOS may report clinically significant symptoms of anxiety or depression at least in part as a result of significant body changes imposed by their illness (eg, hirsutism, irregular menses, obesity, acne, hair thinning). Research done previously indicates that alterations in body image may contribute to psychological distress among women with PCOS.
The literature on neurobiological research in anxiety disorders, anxiety symptoms, depressive disorders, and depressive symptoms among women with PCOS encompasses hypothalamic–pituitary–adrenal (HPA) axis activity and neuroimaging studies.The neurophysiologic etiology of anxiety and depression is not fully understood but the dysregulation of the HPA axis has been linked to stress and, although less extensively, its putative association with anxiety and depression disorders has also been studied.