Depression, anxiety and stress assessment in women with polycystic ovary syndrome attending a tertiary care hospital in bangladesh

Abstract

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 prediagnosed women with PCOS. Psychological symptoms were assessed using the DASS-21. Additionally, 10 in-depth patient interviews and 6 key-informant interviews xvith 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 242 years (standard deviation 5.4) and were prediagnosed cases of PCOS. Married women had higher odds of anxiety' (OR 2.0; 95% Cl 1.1—3.2), while menstrual problems predicted both anxiety (OR 2.0; 95% Cl 1.0-3.4) and stress (OR 2.0; 95% Cl 1.0-3.4). Insomnia significantly predicted anxiety (OR 3.0; 95% Cl 1.4-62) 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.