Document Type : Research Article
Authors
1 Department of Midwifery and Reproductive Health, Mother & Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
2 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
3 School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract
Background: Given the various issues that Polycystic ovary syndrome (PCOS) can cause in women and the need to address its consequences and provide solutions to improve the course of the disease and alleviate its symptoms, the present study aimed to investigate the association between body image and eating disorders, anxiety, and depression in individuals with PCOS.
Methods: This observational study was conducted on 150 girls with PCOS in Hamadan, Iran in 2023. Convenience sampling method was used to select unmarried girls of reproductive age with PCOS. The participants were asked to complete certain questionnaires, including demographic questionnaires, the eating disorders examination questionnaire (EDE-QS), the hospital anxiety and depression scale (HADS), and the body shape questionnaire (BSQ). The collected data were analyzed using Stata-13 software, with a significance level of P<0.05.
Results: The multivariable logistic regression analysis revealed that individuals with concerns about their body image had a significantly higher risk of disordered eating, approximately 25 times greater than those without concerns after adjusting for BMI, age, and PCO duration (Odds Ratio [OR]=29.25; 95%CI: 6.22, 137.67; P<0.001). The results of the logistic regression indicated that individuals with body image concerns were 2.23 times more likely to experience depression (OR=2.23; 95%CI: 1.16, 4.30; P=0.02) and two times more likely to experience anxiety (OR=2.00; 95%CI: 1.04, 3.84; P=0.04) compared with those without concerns.
Conclusions: Large number of girls are concerned about their body image. This causes eating disorders, anxiety and depression in these people. These findings highlight the importance of providing timely and appropriate treatment for PCO.
Highlights
How to Cite: Kazemi F, Fazli S, Tiznobaik A, Soltani F, Ahmadi-Dastjerdi M. The Association between Body Image and Eating Disorders, Anxiety and Depression in Patients with Polycystic Ovary Syndrome (PCOS) in Hamedan, Iran. Women. Health. Bull. 2024;11(4):281-289. doi: 10.30476/whb.2024.103515.1305.
Farideh Kazemi: (Google Scholar)
Keywords
- Aba YA, Şik BA. Body image and sexual function in women with polycystic ovary syndrome: a case-control study. Rev Assoc Med Bras. 2022;68(9):1264-1269. doi: 10.1590/1806-9282.20220367. PubMed PMID: 36134774; PubMed Central PMCID: PMC9575011. ##
- Suchta K, Smolarczyk R, Czajkowski K, Rudnicka E, Kokoszka A. Binge Eating Disorder-The Point Prevalence among Polish Women with Polycystic Ovary Syndrome and Validity of Screening Tool for This Population. Int J Environ Res Public Health. 2022;20(1):546. doi: 10.3390/ijerph20010546. PubMed PMID: 36612867; PubMed Central PMCID: PMC9819692. ##
- Hopkins CS, Kimble AP, Hodges HF, Koci AF, Mills BB. A mixed-methods study of coping and depression in adolescent girls with polycystic ovary syndrome. J Am Assoc Nurse Pract. 2019;31(3):189-197. doi:10.1097/jxx.0000000000000125. PubMed PMID: 30681649. ##
- Alur-Gupta S, Chemerinski A, Liu C, Lipson J, Allison K, Sammel MD, et al. Body-image distress is increased in women with polycystic ovary syndrome and mediates depression and anxiety. Fertil Steril. 2019;112(5):930-938. doi: 10.1016/j.fertnstert.2019.06.018. PubMed PMID: 31395311; PubMed Central PMCID: PMC6858949. ##
- Javed H, Niazi S, Adil A, Yousaf A, Khan A, Ghayas S. Body image concern as mediator between obesity and sexual satisfaction: a comparative study of married women with and without polycystic ovarian syndrome. RMJ. 2022;47(2):400-402. ##
- Shakil M, Ashraf F, Wajid A. Sexual functioning as predictor of depressive symptoms and life satisfaction in females with polycystic ovary syndrome (Pcos). Pak J Med Sci. 2020;36(7):1500-1504. doi: 10.12669/pjms.36.7.2562. PubMed PMID: 33235564; PubMed Central PMCID: PMC7674907. ##
- Miri N, Nowrozi M, Zavoshi R, Mohammadpoorasl A, Khoeiniha M. Association between eating disorders and body image in athletes and non-athlete students in Qazvin University of Medical Sciences. J Qazvin Univ Med Sci. 2016;20(2):26-33. Persian. ##
- Golian S, Ghiyasvand M, Mirmohamad Ali M, Mehran A. The relationship between body image of obese adolescent girls and depression, anxiety and stress. Payesh. 2014;13(4):433-440. Persian. ##
- Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod. 2017;32(5):1075-1091. doi: 10.1093/humrep/dex044. PubMed PMID: 28333286. ##
- Greenwood EA, Pasch LA, Cedars MI, Legro RS, Huddleston HG, Eunice Kennedy Shriver Natl Inst C. Association among depression, symptom experience, and quality of life in polycystic ovary syndrome. Am J Obstet Gynecol. 2018;219(3):279. doi: 10.1016/j.ajog.2018.06.017. PubMed PMID: 29969586; PubMed Central PMCID: PMC6758922. ##
- Dybciak P, Humeniuk E, Raczkiewicz D, Krakowiak J, Wdowiak A, Bojar I. Anxiety and Depression in Women with Polycystic Ovary Syndrome. Medicina. 2022;58(7):942. doi: 10.3390/medicina58070942. PubMed PMID: 35888661; PubMed Central PMCID: PMC9319705. ##
- Pirotta S, Barillaro M, Brennan L, Grassi A, Jeanes YM, Joham AE, et al. Disordered Eating Behaviours and Eating Disorders in Women in Australia with and Without Polycystic Ovary Syndrome: A Cross-Sectional Study. J Clin Med. 2019;8(10):1682. doi: 10.3390/jcm8101682. PubMed PMID: 31615157; PubMed Central PMCID: PMC6832459. ##
- Kolnikaj TS, Herman R, Janez A, Jensterle M. Assessment of Eating Disorders and Eating Behavior to Improve Treatment Outcomes in Women with Polycystic Ovary Syndrome. Life. 2022;12(11):1906. doi: 10.3390/life12111906. PubMed PMID: 36431041; PubMed Central PMCID: PMC9692921. ##
- Green SB. How Many Subjects Does It Take To Do A Regression Analysis. Multivariate Behav Res. 1991;26(3):499-510. doi: 10.1207/s15327906mbr2603_7. PubMed PMID: 26776715. ##
- Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of Anxiety and Depression Hospital Scales (HADS): Iranian patients with anxiety and depression disorders Tehran Univ Med J. 2009;67(5):379-385. Persian. ##
- Sadeghi K, Ahmadi SM, Rezaei M, Veisy F, Raeesi F, Shahverdi J. Psychometric properties of the 34-item Body Shape Questionnaire in students. 2014;18(6):e74083. doi: 10.22110/jkums.v18i6.1886. ##
- Gideon N, Hawkes N, Mond J, Saunders R, Tchanturia K, Serpell L. Development and Psychometric Validation of the EDE-QS, a 12 Item Short Form of the Eating Disorder Examination Questionnaire (EDE-Q). PLoS One. 2016;11(5):e0152744. doi: 10.1371/journal.pone.0152744. PubMed PMID: 27138364; PubMed Central PMCID: PMC4854480. ##
- Prnjak K, Mitchison D, Griffiths S, Mond J, Gideon N, Serpell L, et al. Further development of the 12-item EDE-QS: identifying a cut-off for screening purposes. BMC Psychiatry. 2020;20(1):146. doi: 10.1186/s12888-020-02565-5. PubMed PMID: 32245441; PubMed Central PMCID: PMC7118929. ##
- Mousavi Asl E, Mahaki B, Khanjani S, Mohammadian Y. Assessment of eating disorder psychopathology: The psychometric properties of the Persian version of the Eating Disorder Examination Questionnaire Short Form. J Res Med Sci. 2021;26:71. doi: 10.4103/jrms.JRMS_230_20. PubMed PMID: 34759988; PubMed Central PMCID: PMC8548889. ##
- Salkind NJ. Statistics for People Who (Think They) Hate Statistics: SAGE Publications; 2010. ##
- Parvaneh M, Babaei Bonab S. Psychological Status of Adolescent Girls with Polycystic Ovary Syndrome During Coronavirus Outbreak: The Effect of 12 Weeks of Home-Based Aerobic Exercise. sjsph. 2021;19(1):69-84. Persian. ##
- Annagur BB, Tazegul A, Akbaba N. Body Image, Self-Esteem and Depressive Symptomatology in Women with Polycystic Ovary Syndrome. Noro Psikiyatr Ars. 2014;51(2):129-132. doi: 10.4274/npa.y6778. PubMed PMID: 28360612; PubMed Central PMCID: PMC5353087. ##
- Shamseddin-Saeed N, Azizzadeh-Forouzi M, Mohammad-Alizadeh S, Haghdoost AA, Garousi B. Relationship between body image and eating disorders. Iranian Journal of Nursing Research. 2010;15(4):33-43. Persian. ##
- Kazemi Z, Aghamohamadi S, Khanzadeh M. Structural Model of Eating Disorders Symptoms in Women Based on the Internalization of Media Models, Eating-ralated Beliefs and body dysmorphic concern. Journal of Clinical Psychology Studies. 2022;12(46):66-92. doi: 10.22054/JCPS.2022.62337.2607. Persian. ##
- Boberová Z, Husárová D. What Role Does Body Image in Relationship between Level of Health Literacy and Symptoms of Eating Disorders in Adolescents? Int J Environ Res Public Health. 2021;18(7):3482. doi: 10.3390/ijerph18073482. PubMed PMID: 33801635; PubMed Central PMCID: PMC8036840. ##
- SeyyedSalehi SF, DashtBozorgi Z. The Relationship between Personality Characteristics, Body Image Concern and Alexithymia with Eating Disorder of Nursing Students. IJNR. 2018;13(4):1-8. doi: 10.21859/ijnr-13041. Persian. ##
- Kogure GS, Ribeiro VB, Lopes IP, Furtado CLM, Kodato S, Silva de Sá MF, et al. Body image and its relationships with sexual functioning, anxiety, and depression in women with polycystic ovary syndrome. J Affect Disord. 2019;253:385-393. doi: 10.1016/j.jad.2019.05.006. PubMed PMID: 31082731. ##
- Pastore LM, Patrie JT, Morris WL, Dalal P, Bray MJ. Depression symptoms and body dissatisfaction association among polycystic ovary syndrome women. J Psychosom Res. 2011;71(4):270-6. doi: 10.1016/j.jpsychores.2011.02.005. PubMed PMID: 21911106; PubMed Central PMCID: PMC3172572. ##
- Gaskin JL, Pulver AJ, Branch K, Kabore A, James T, Zhang J. Perception or reality of body weight: which matters to the depressive symptoms. J Affect Disord. 2013;150(2):350-5. doi: 10.1016/j.jad.2013.04.017. PubMed PMID: 23706878. ##
- Brechan I, Kvalem IL. Relationship between body dissatisfaction and disordered eating: mediating role of self-esteem and depression. Eat Behav. 2015;17:49-58. doi: 10.1016/j.eatbeh.2014.12.008. PubMed PMID: 25574864. ##
- Mojtahedzadeh F, Mashayekh A. Relationship between body image and physical fitness with depression, anxiety and stress in female students from Nour city. Quarterly Journal of Educational Psychology 2022;12(4):52-66. Persian. ##
- Pujols Y, Seal BN, Meston CM. The association between sexual satisfaction and body image in women. J Sex Med. 2010;7(2 Pt 2):905-16. doi: 10.1111/j.1743-6109.2009.01604.x. PubMed PMID: 19968771; PubMed Central PMCID: PMC2874628. ##
- Scheffers M, van Duijn MAJ, Beldman M, Bosscher RJ, van Busschbach JT, Schoevers RA. Body attitude, body satisfaction and body awareness in a clinical group of depressed patients: An observational study on the associations with depression severity and the influence of treatment. J Affect Disord. 2019;242:22-28. doi: 10.1016/j.jad.2018.08.074. PubMed PMID: 30170235. ##
- Joshi RD, Sawant N, Mayadeo NM. How Common are Depressive-Anxiety States, Body Image Concerns and Low Self-Esteem in Patients of PCOS? J Obstet Gynaecol India. 2022;72(1):72-77. doi: 10.1007/s13224-021-01505-x. PubMed PMID: 35125741; PubMed Central PMCID: PMC8804144. ##