Depression, anxiety and stress assessment in women with polycystic ovary syndrome attending a tertiary care hospital in Bangladesh
DOI:
https://doi.org/10.3329/bsmmuj.v18i1.78898Keywords:
depression, anxiety, stress, PCOSAbstract
Background: This study evaluated depression, anxiety, and stress in women with polycystic ovary syndrome (PCOS) using the depression, anxiety, and stress scale-21 (DASS-21) and examined their live experiences with this endocrine disorder.
Methods: A mixed-methods study, combining an analytical cross-sectional study and qualitative grounded theory, was conducted from February to June 2022 at Bangabandhu Sheikh Mujib Medical University. The study involved 266 pre-diagnosed women with PCOS. Psychological symptoms were assessed using the DASS-21. Additionally, 10 in-depth patient interviews and 6 key-informant interviews with mothers explored the personal and societal dynamics of PCOS.
Results: The survey revealed significant psychological distress among participants, with 32% as "moderate" for depression, 68% as "extremely severe" for anxiety, and 45% as "severe" for stress. Participants had a mean age of 24.2 years (standard deviation 5.4) and were pre-diagnosed cases of PCOS. Married women had higher odds of anxiety (OR 2.0; 95% CI 1.1‒3.2), while menstrual problems predicted both anxiety (OR 2.0; 95% CI 1.0‒3.4) and stress (OR 2.0; 95% CI 1.0‒3.4). Insomnia significantly predicted anxiety (OR 3.0; 95% CI 1.4‒6.2) and stress (OR 2.3; 95% CI 1.1‒5.1). Societal stigma compounded these challenges, with unmarried girls concerned about acne and hirsutism, and their mothers focusing on menstrual irregularities and fertility. Married women delayed care-seeking by 2–3 years, driven by infertility concerns, highlighting societal pressures around marriage and childbearing as more significant stressors than PCOS itself.
Conclusion: Women with PCOS face significant mental health challenges which are exacerbated by marital status, insomnia, menstrual issues, and societal stigma. Family support plays a role in coping with the condition.
Downloads
464
130 PDF
121 Review report
35
References
Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci. 2020 Oct-Dec;13(4):261-271. doi: https://doi.org/10.4103/jhrs.JHRS_95_18
Chakravorty T. Understanding Polycystic Ovary Syndrome (PCOS): The physician. 2023 Jul 15;8(2):1–8. doi: https://doi.org/10.38192/1.8.2.3
Islam H, Masud J, Islam YN, Haque FKM. An update on polycystic ovary syndrome: A review of the current state of knowledge in diagnosis, genetic etiology, and emerging treatment options. Womens Health (Lond). 2022 Jan-Dec;18:17455057221117966. doi: https://doi.org/10.1177/17455057221117966
World Health Organization. Polycystic ovary syndrome [Internet]. World Health Organization. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome [ Access Date: 2024 May 28]
De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F. Genetic, hormonal and metabolic aspects of PCOS: an update. Reproductive Biology and Endocrinology [Internet]. 2016 Jul 16;14(1). doi: https://doi.org/10.1186/s12958-016-0173-x
Chaudhari AP, Mazumdar K, Mehta PD. Anxiety, Depression, and Quality of Life in Women with Polycystic Ovarian Syndrome. Indian Journal of Psychological Medicine [Internet]. 2018;40(3):239–246. doi: https://doi.org/10.4103/IJPSYM.IJPSYM_561_1
Struijs SY, de Jong PJ, Jeronimus BF, van der Does W, Riese H, Spinhoven P. Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. Journal of Affective Disorders [Internet]. 2021 Dec 1; 295:1347–1359. doi: https://doi.org/10.1016/j.jad.2021.08.086
Kamrul-Hasan AM, Aalpona FZ, Mustari M, Selim S. Prevalence and characteristics of women with polycystic ovary syndrome in Bangladesh – A narrative review. Bangladesh Journal of Endocrinology and Metabolism. 2023 Jan 1;2(1):1–9. doi: https://doi.org/10.4103/bjem.bjem_14_22
Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI journal [Internet]. 2017 Jul 21;16(1):1057–1072. doi: https://doi.org/10.17179/excli2017-480
Keng SL, Smoski MJ, Robins CJ. Effects of Mindfulness on Psychological health: a Review of Empirical Studies. Clinical Psychology Review [Internet]. 2011;31(6):1041–1056. doi: https://doi.org/10.1016/j.cpr.2011.04.006
Mughal AY, Devadas J, Ardman E, Levis B, Go VF, Gaynes BN. A systematic review of validated screening tools for anxiety disorders and PTSD in low to middle income countries. BMC Psychiatry. 2020 Jun 30;20(1):338. doi: https://doi.org/10.1186/s12888-020-02753-3
Alim SAHM, Kibria SME, Lslam MJ, Uddin MZ, Nessa M, Wahab MA, Islam MM. Translation of DASS 21 into Bangla and validation among medical students. Bangladesh Journal of Psychiatry. 2017 Jun 7;28(2):67–70. doi: https://doi.org/10.3329/bjpsy.v28i2.32740
Talbott EO, Zborowski JV, Rager JR, Kip KE, Xu X, Orchard TJ. Polycystic ovarian syndrome (PCOS): a significant contributor to the overall burden of type 2 diabetes in women. J Womens Health (Larchmt). 2007 Mar;16(2):191-197. doi: https://doi.org/10.1089/jwh.2006.0098
Faruk MO, Khan AH, Chowdhury KUA, Jahan S, Sarker DC, Colucci E, Hasan MT. Mental illness stigma in Bangladesh: Findings from a cross-sectional survey. Glob Ment Health (Camb). 2023 Sep 18;10:e59. doi: https://doi.org/10.1017/gmh.2023.56
Khan MJ, Ullah A, Basit S. Genetic Basis of Polycystic Ovary Syndrome (PCOS): Current Perspectives. Appl Clin Genet. 2019 Dec 24;12:249-260. doi: https://doi.org/10.2147/TACG.S200341
Payne N, Seenan S, van den Akker O. Experiences and psychological distress of fertility treatment and employment. J Psychosom Obstet Gynaecol. 2019 Jun;40(2):156-165. doi: https://doi.org/10.1080/0167482X.2018.1460351
Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, O'Leary MP, Puppo P, Robertson C, Giuliano F. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003 Dec;44(6):637-649. doi: https://doi.org/10.1016/j.eururo.2003.08.015
Dybciak P, Humeniuk E, Raczkiewicz D, Krakowiak J, Wdowiak A, Bojar I. Anxiety and Depression in Women with Polycystic Ovary Syndrome. Medicina (Kaunas). 2022 Jul 16;58(7):942. doi: https://doi.org/10.3390/medicina58070942
Davitadze M, Malhotra K, Khalil H, Hebbar M, Tay CT, Mousa A; PCOS SEva team; Teede H, Brennan L, Stener-Victorin E, Kempegowda P. Body image concerns in women with polycystic ovary syndrome: a systematic review and meta-analysis. Eur J Endocrinol. 2023 Aug 2;189(2):R1-R9. doi: https://doi.org/10.1093/ejendo/lvad110
Masuko N, Tanimura K, Kojima N, Imafuku H, Deguchi M, Okada Y, Hirota Y, Ogawa W, Yamada H. Predictive factors for postpartum glucose intolerance in women with gestational diabetes mellitus. J Obstet Gynaecol Res. 2022 Mar;48(3):640-646. doi: https://doi.org/10.1111/jog.15155
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Fariha Haseen, Shahjada Selim, Rezaul Karim Kazal, Mohammad Shamsul Ahsan, Nurjahan Akter, Hridi Hedayet, Umme Haney, Begum Nasrin, Syed Shariful Islam

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.