Body image, illness perception, and psychological distress in women coping with polycystic ovary syndrome (PCOS)

Objective: While symptoms of polycystic ovary syndrome (PCOS) and psychological distress (PD) are directly linked, indirect effects are also apparent. The present study aims to develop an explanatory model for the effect of PCOS on women' PD and identify possible protective and risk factors. It examines the development of PD in women with PCOS and further investigates the association between body image, both positive (body appreciation) and negative (body dissatisfaction) dimensions, and PD as well as the potential mediating effect of illness perception on this association. Methods: This study comprised a total of 316 women aged 20-50 (M = 30.9, SD = 6.3) - 197 women with PCOS and 119 healthy peers-who completed questionnaires regarding demographic characteristics, anxiety (GAD-7), depression (PHQ-9), body appreciation (BAS-2), body dissatisfaction (EDI-BD), and the Brief Illness Perception Questionnaire (BIPQ). Results: Significant differences between groups were found in all measures. Body appreciation mediated the link between PCOS and PD, while body appreciation and illness perception also mediated the link between symptom level and PD among PCOS patients. Conclusion: Women with PCOS face considerable psychological strain and highlight body appreciation and illness perception as two underlying psychological mechanisms that contribute to the increased risk of distress. Interventions addressing both mechanisms may help improve PD in women with PCOS.