Racial differences in anxiety, depression and quality of life in women with Polycystic Ovary Syndrome

Abstract Objective To evaluate racial differences in anxiety and depression prevalence and scores in women with polycystic ovary syndrome (PCOS). Design Cross-sectional Setting Academic institution Patients Reproductive-aged with PCOS (n=272) and Controls (n=295) Intervention Hospital Anxiety and Depression Scale (HADS) and modified PCOS Quality of Life Survey (MPCOS-Q). Main Outcome Measures Depression, anxiety scores and quality of life score differences were measured in White and Black women with PCOS using the HADS and MPCOS-Q. Multivariable correlation regressions assessed the association of FG score, total testosterone, BMI and HOMA-IR with anxiety, depression and quality of life scores. Results Multivariable regression controlling for age, BMI and SES showed White women with PCOS had a significantly higher prevalence of anxiety than Black women with PCOS (75.9% vs 61.3%, p=0.014) and significantly higher anxiety scores (mean 10.3 + 4.1 vs 8.7 + 4.6, p=0.006). Prevalence of depression (24.4% vs 29%, p=0.933) and depression scores (4.8 + 3.6 vs 5.1 + 4.0, p=0.659) were not significantly different. In multivariable correlation regressions, the interaction between BMI and race in its association with anxiety scores was significant (p=0.031). The association of race with FG score, total testosterone or HOMA-IR 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 12.6 + 7.8 vs mean 17.5 + 6.8, p=0.001) indicating 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.