(43) Eating attitudes, sleep quality, and self-esteem in adolescents diagnosed with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorder in women of reproductive age. In addition to its known association with various metabolic abnormalities such as obesity, dyslipidemia, glucose intolerance, and hypertension, an increased prevalence of psychological and behavioral disorders has also been reported in individuals with PCOS. Despite this connection, relatively very few studies have been performed for adolescents. The objective of this study was to evaluate the associations between PCOS and eating attitudes, self-esteem, and sleep quality in a sample of adolescents.

Methods: This cross-sectional case–control study was conducted between October 2021 and September 2023. The study group consisted of adolescents aged 13-21 who were diagnosed with PCOS based on current international suggestions with properly defined irregular menstrual cycles and clinical/biochemical hyperandrogenism. Exclusion criteria were having a history of chronic disease, psychiatric disorder, or eating disorder. The control group comprised age-matched healthy volunteer adolescents. All adolescents were asked to complete Eating Attitudes Test (EAT-26), Pittsburgh questionnaire (PSQI), and the Rosenberg Self-Esteem Scale (RSES). Basal hormonal and metabolic parameters used in the diagnosis and monitoring of PCOS were also evaluated for the study group.

Results: A total of 90 adolescents with PCOS and 110 age-matched healthy peers were recruited. Adolescents with PCOS and their healthy peers did not differ in most of the background characteristics summarized in Table 1, but BMI was significantly higher in the PCOS group. Compared with control group, EAT-26 score was found to be 20 or higher more frequently in adolescents with PCOS (23.3% vs 12.7%, P=0.049). Moreover, adolescents with PCOS reported higher rates of low self-esteem (28.9% vs 15.4%, P=0.021). A significant difference in EAT-26 total score was also noted between two groups (13.9±0.9 vs 11.3±0.9, P=0.04). Obesity was not associated with disordered eating attitudes and low self-esteem (P=0.48 and P=0.163, respectively). There was no significant differences in the PCOS and control groups in terms of PSQI total score (Table 2).

Conclusions: The findings of this study suggest that adolescents with PCOS are more likely to experience disturbances in eating attitudes and report low self-esteem. Physicians should be aware of and screen for these psychological and behavioral consequences of PCOS on adolescents, which may also interfere with lifestyle interventions recommended for treatment.