Comparison of patients with polycystic ovary syndrome and healthy controls in terms of body image, self-esteem, eating behavior, impulsivity, comorbid psychiatric diseases and investigating the correlation between hormone levels and symptoms

Introduction: Polycystic ovary syndrome is the most frequently diagnosed endocrinological disorder in women in the reproductive period. Hirsutism, acne, increased body mass index, menstrual irregularities, increased infertility and malignancy risk also bring psychological problems. In our study, we aimed to screen these patients for axis 1 and axis 2 disorders and to show the relationship between depression, anxiety, eating disorder, impulsivity, body image, self-esteem, clinical findings of the syndrome and hormone parameters. Materials and Methods: Our research is a single-center, cross-sectional, parallel controlled study. 51 patients over the age of 18 who applied to the Obstetrics and Gynecology outpatient clinic, diagnosed with polycystic ovary syndrome according to the Rotterdam Criteria, and 44 healthy controls without PCOS diagnosis were included in the study. SCID-I and SCID-II scales, Beck depression and anxiety scales, eating attitude test, Barratt impulsivity scale, Rosenberg self-esteem scale and body image scale were administered to 95 participants who met the conditions for participation in the study. Sociodemographic information such as age, education, marital status of the participants, acne, hirsutism complaints, height, weight and BMI were noted. Hormone values of the participants with PCOS were recorded. Results: In our study, we found significantly higher depression, anxiety, eating disorder, personality disorder, impaired body image and self-esteem in patients with PCOS . In SCID I, 39.2% of the patients had a psychiatric disease. Those were 27.5% major depressive disorder, 21.6% generalized anxiety disorder and 13.7% eating disorder. The patients' Beck depression, Beck anxiety, Barratt total score and subscale scores, eating attitude total score, and eating attitude diet and eating attitude ambivalent scores, body image and Rosenberg self-esteem scores were significantly higher than controls. According to SCID-II test, 37.3% of them were found to have axis 2 personality disorder. Avoidant personality disorder was found to be significantly higher than controls. 25.5% of the patients and 9.1% of the controls were found to be obese. Those with obesity had more axis 1 diagnoses, more depression, and more eating disorders than those without. Bulimia Nervosa, was significantly more common in obese patients. Conclusion: In our study, we found significantly higher depression, anxiety, eating disorder, personality disorder, impaired body image and self-esteem in patients with PCOS. We have seen that clinical findings rather than blood parameters have an impact on these disorders. After the diagnosis of PCOS, patients are recommended to be referred to psychiatry for diagnosis, follow-up and treatment of these comorbid psychiatric disorders. Key Words: PCOS, depression, anxiety, personality disorder, eating disorder, impulsivity, body image, self-esteem