Date of Award

12-2020

Degree Type

Thesis

Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)

First Advisor

Dr. Shafquat Rozi

Second Advisor

Ms. Maryam Pyar Ali Lakhdir

Department

Community Health Sciences

Third Advisor

Dr. Nargis Asad

Abstract

Background: Clinical-stigmata inherent in Polycystic ovarian syndrome (PCOS), including hormonal and aesthetic changes, can impair the quality of life of individuals, predominantly adolescents and youth who are most vulnerable to its impact. Depression could be one of the factors influencing the quality of life as there exists a possibility that depression might modulate how an individual perceives her symptoms, eventually affecting the quality of life. It is essential to determine the quality of life and its associated factors as it is a critical step towards identifying the adequate measures and interventions required to ensure the overall psychological, physical, and social well-being of patients with PCOS.
Objectives: The study investigated the association between depression and quality of life in Pakistani adolescents and youth (15-24 years) with PCOS and also determined other factors influencing the quality of life.
Methods: We conducted a web-based analytical-cross-sectional survey on 213 single Pakistani females aged 15-24 years who had self-reported PCOS. The study questionnaire was broadcasted on the internet via Google forms. The Google form link was made available to the target population via various social media platforms (Facebook, Twitter, Instagram), WhatsApp messages, and SMS. Individuals with internet availability were able to access the questionnaire by clicking on the link. Depression and quality of life were assessed through the Center of Epidemiological Studies Depression tool and polycystic ovarian syndrome quality of life scale. Multiple linear regression was the choice of analysis, and adjusted regression coefficients along with a 95% confidence interval were reported.
Results: The mean age of participants in this study was 21.4+1.89 years. Majority of the participants were residents of Sindh(64.3%), belonged to middle-class backgrounds(72.7%), and had graduation/post-graduation as their highest level of education(69.0%). The mean overall quality of life score was 2.9+0.3. The most affected domains of quality of life were obesity/weight gain (2.5+0.1) and emotional health(2.9+0.4). The least distressing domain was hirsutism(3.2+0.1). 172 out of 213 (80.0%) participants were screened positive for depressive symptoms. Depressed participants reported reduced mean overall quality of life scores compared to non[1]depressed counterparts (2.8+0.3 vs. 3.5+0.5, p< 0.001). We found a significant interaction between depression and duration of PCOS,indicating that the estimated mean overall QOL score was 25.1(-36.6, -13.6) lower for every year increase in PCOS duration since the first diagnosis among participants screened positive for depression. Furthermore, for those respondents who had a family history of PCOS and were not satisfied with their healthcare giver treating PCOS, the estimated mean QOL score was 17.47(-26.11, -8.82) lower than participants who had no family history of PCOS and were satisfied with their healthcare giver. Social pressure to improve appearance affected by PCOS, constant parental criticism related to PCOS, BMI, socioeconomic status, education, and employment status were other significant predictors of quality of life (p-value< 0.001).
Conclusion: Depression was significantly associated with reduced quality of life. Therefore, to improve the symptoms and overall quality of life of PCOS victims, screening and treatment of psychological morbidities should be considered. Moreover, counselling and training health professionals and families to understand the implications and mental stresses the PCOS victims go through might also improve their quality of life.

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1

Last Page

125

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