(138) Depression and Anxiety in Young Women Diagnosed with PCOS during Adolescence

Background: Guidelines recommend that all adolescents with PCOS be screened for anxiety/depression. Adolescents with PCOS have lower quality of life scores as compared to healthy peers and higher rates of anxiety/depression. In adults with PCOS, those with higher BMIs were more likely to have anxiety/depression compared to adults without PCOS. Our study aim was to calculate rates of lifetime anxiety/depression diagnoses in young adults diagnosed with PCOS during adolescence and to evaluate potential contributing factors.

Methods: In this cross-sectional study, we surveyed young adults diagnosed with PCOS (n=439) as adolescents between 6/2012-6/2016. Surveys were sent between 11/2022 & 6/2023. Participants reported on their demographic, reproductive, and anthropometric measures as well as diagnoses and medication use. Participants reported if they were diagnosed with anxiety/depression requiring medication or therapy. We assessed the proportion of those with anxiety/depression and associated factors using Fisher’s exact test for categorical variables and Mann WhitneyU tests for continuous variables.

Results: Sixty-two individuals completed the questionnaire; 75% were lost-to-follow-up due to outdated contact information. The mean age was 24.7 years (SD=3.2; range=18-33), 77% self-identified as White, and 66% reported current obesity. Rates of ever being diagnosed with anxiety and/or depression were high (48% & 42%, respectively). On average, those with anxiety had been diagnosed at age 14 years (SD=5.8) and those with depression at age 14.8 years (SD=5.9). Anxiety and depression diagnoses overlapped considerably; 80% of participants with anxiety also reported a diagnosis of depression, and only 6% of those without anxiety reported depression (p < 0.001). Participants with anxiety and/or depression were more likely to identify as obese (77%) compared to those who had never received a diagnosis of anxiety or depression (57% obese; p=0.10). We did not observe differences by anxiety/depression status for acne, hirsutism, metformin, or oral contraceptive pill use (ever or current).

Conclusions: Our study demonstrates substantial rates of anxiety/depression in individuals diagnosed with PCOS as adolescents. Those who had anxiety/depression were possibly more likely to have an elevated BMI. Our study corroborates the importance of screening for and treating behavioral health concerns in those who are diagnosed with PCOS as adolescents. It does not appear that acne, hirsutism, use of metformin, or oral contraceptive pills are contributing factors to the development of behavioral health concerns. Future studies will further evaluate these associations in a larger cohort.