Adult psychological outcomes among women with different adolescent PCOS presentations

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder, often beginning in adolescence and associated with reproductive, metabolic, and psychological complications. The present study evaluated whether adolescent patients meeting the 2023 adolescent-specific PCOS criteria (Rotterdam phenotypes A and B) exhibit poorer mental health or lower quality of life (QoL) in adulthood compared with those with Rotterdam PCOS phenotypes C and D.

A retrospective analysis was conducted among women previously hospitalized in pediatric endocrinology wards and diagnosed with PCOS during adolescence. Clinical data, hormonal profiles, and comorbidities were extracted from medical records. The study group [SG] comprised patients with Rotterdam PCOS phenotypes A and B, while the comparison group [CG] included phenotypes C and D and adolescents at risk of PCOS. In adulthood, participants completed a 66-item survey including self-reported BMI, menstrual symptoms, Ferriman-Gallwey scoring, comorbidity assessment, the Patient Health Questionnaire-9 (PHQ-9), and the WHOQOL-BREF.

A total of 46 individuals completed the survey, including 32 participants in the SG and 14 in the CG. The median age was 22.5 years in the SG and 21.5 years in the CG. All participants were Polish. During adolescence, SG and CG differed in testosterone levels (p = 0.0007) and number of patients with menstrual irregularities (p = 0.006). In adulthood, no significant between-group differences were observed in BMI, Ferriman-Gallwey scores, PHQ-9 outcomes, or WHOQOL-BREF domain scores. The distribution of depressive symptom severity did not differ significantly. Moreover, no correlations were found between QoL or depressive symptoms and BMI change, disease duration or hirsutism. However, mean PHQ-9 scores in both groups indicated clinically relevant depressive symptoms.

Adult women diagnosed with PCOS (Rotterdam phenotypes A and B) in adolescence did not exhibit poorer quality of life or increased depressive symptoms compared with women presenting Rotterdam PCOS phenotypes C and D or adolescents previously classified as being at risk of PCOS. No significant differences were observed between groups in PHQ-9 or WHOQOL-BREF scores, nor were these outcomes related to BMI, hyperandrogenism, or disease duration. Both groups demonstrated elevated depressive symptom levels, highlighting the need for longitudinal studies on long-term psychological outcomes in PCOS.