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Hum. Reprod. Advance Access originally published online on February 16, 2009
Human Reproduction 2009 24(6):1446-1451; doi:10.1093/humrep/dep031
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Prevalence and implications of anxiety in polycystic ovary syndrome: results of an internet-based survey in Germany

S. Benson1, S. Hahn2, S. Tan3, K. Mann3, O.E. Janssen4, M. Schedlowski1 and S. Elsenbruch1,5

1 Institute of Medical Psychology and Behavioral Immunobiology, University Clinic of Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany 2 Endokrinologische Praxis, Wuppertal, Germany 3 Division of Endocrinology, Department of Medicine, University Clinic of Essen, University of Duisburg-Essen, Germany 4 Endokrinologikum Hamburg, Center for Endocrine and Metabolic Diseases, Hamburg, Germany

5 Correspondence address. Tel: +49-201-723-4502; Fax: +49-201-723-5948; E-mail: sigrid.elsenbruch{at}uk-essen.de

BACKGROUND: Comparatively little attention has been paid to the symptoms of anxiety in polycystic ovary syndrome (PCOS), although anxiety disorders constitute the most common psychiatric diagnoses among endocrine patients and in the general population. Therefore, our goal was to address the prevalence, determinants and implications of anxiety alone or anxiety in combination with depression in German women with PCOS.

METHODS: In this nation-wide, internet-based survey, anxiety and depression (Hospital Anxiety and Depression Scale, HADS) and quality of life (SF-12) were assessed together with sociodemographic information and clinical PCOS symptoms in 448 PCOS women.

RESULTS: Of the patients, 34% showed clinically relevant HADS anxiety scores and 21% had clinically relevant HADS depression scores. Quality of life was significantly impaired in PCOS women with anxiety (P < 0.001), in particular, in women with comorbid anxiety and depression (P < 0.001). The risk for clinically relevant HADS anxiety scores was significantly enhanced in PCOS women with acne (odds ratio (OR) = 1.52; 95% confidence interval (CI) = 1.03–2.52) and an unfulfilled wish to conceive (OR = 1.50; 95% CI = 1.01–2.23).

CONCLUSIONS: PCOS women may be at an increased risk for clinically relevant anxiety, and comorbid anxiety and depression is also very common. Anxiety contributes to impaired quality of life in PCOS. Given the high prevalence and the serious implications, and the availability of effective treatment options given proper diagnosis, clinicians should be more aware of anxiety disorders in women with PCOS.

Key words: PCOS/anxiety/depression/quality of life

Submitted on November 25, 2008; resubmitted on January 14, 2009; accepted on January 20, 2009.


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E. Jedel, M. Waern, D. Gustafson, M. Landen, E. Eriksson, G. Holm, L. Nilsson, A.-K. Lind, P.O. Janson, and E. Stener-Victorin
Anxiety and depression symptoms in women with polycystic ovary syndrome compared with controls matched for body mass index
Hum. Reprod., November 19, 2009; (2009) dep384v1.
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