Racial differences in anxiety, depression, and quality of life in women with polycystic ovary syndrome

Objective: To evaluate racial differences in the anxiety and depression prevalence and scores in women with polycystic ovary syndrome (PCOS).

Design: Cross-sectional.

Setting: Academic institution.

Patients: Reproductive-aged women with PCOS (n = 272) and controls (n = 295).

Interventions: Hospital anxiety and depression scale and modified PCOS quality-of-life survey (MPCOS-Q).

Main outcome measures: Differences in depression and anxiety scores and quality-of-life score measured using the hospital anxiety and depression scale and MPCOS-Q were determined between White and Black women with PCOS. Multivariable correlation regressions assessed the association of the Ferriman-Gallwey score, total testosterone, body mass index (BMI), and homeostatic model assessment of insulin resistance with anxiety, depression, and quality-of-life scores.

Results: Multivariable regression controlling for age, BMI, and socioeconomic status showed that White women with PCOS had a significantly higher prevalence of anxiety than Black women with PCOS (75.9% vs. 61.3%) and significantly higher anxiety scores (mean ± SD, 10.3 ± 4.1 vs. 8.7 ± 4.6). The prevalence of depression (24.4% vs. 29%) and depression scores (4.8 ± 3.6 vs. 5.1 ± 4.0) was not significantly different. In multivariable correlation regressions, the interaction between BMI and race in its association with anxiety scores was significant. The association of race with Ferriman-Gallwey score, total testosterone, or homeostatic model assessment of insulin resistance was not significant. In multivariable models, although the total MPCOS-Q scores were similar, the infertility domain was significantly lower in Black women with PCOS (mean ± SD, 12.6 ± 7.8 vs. 17.5 ± 6.8) indicating a lower quality of life related to infertility.

Conclusion: Racial differences identified in the prevalence of anxiety and MPCOS-Q domains suggest the importance of routine screening and provide an opportunity for targeted interventions based on race.