Prevalence of anxiety and depression among women with Polycystic Ovary Syndrome living in war versus non-war zone countries: A randomized controlled trial assessing a pharmacist intervention

Abstract

Background: Polycystic ovary syndrome (PCOS) is a serious health problem. In women experiencing PCOS, there are myriad physical and mental health consequences; anxiety/depression are commonly associated with this condition. Community pharmacists are in a pivotal position to identify and help women diagnosed with PCOS.

Objectives: To investigate the prevalence/severity of anxiety/depression among females diagnosed with PCOS living in Syria (a war-zone country) and Jordan (a non-war zone country). Secondly, to evaluate the impact of a pharmaceutical care service delivered by a clinical pharmacist on participants' anxiety/depression severity.

Methods: Females, diagnosed with PCOS above the age of 16, were recruited into the study and randomly allocated into either the active or the control group. The active group participants received a PCOS pharmaceutical care service. This service involved the provision of verbal and written educational materials, with a special focus on diet and exercise. The control group participants received only standard counseling. Both groups were followed up for four months. All participants completed the Beck Anxiety Inventory and the Beck Depression Inventory at baseline and follow-up.

Results: Data from study participants (n = 118) from both Syria (n = 60) and Jordan (n = 58) highlighted a high prevalence of anxiety (Syria = 95% vs. Jordan = 98%) and depression (Syria = 83% vs. Jordan = 65%). At follow-up, active group participants, from both countries, showed significant improvements in anxiety and depression mean scores (anxiety: Syria = 34.97 ± 14.8 vs. 30.47 ± 14.3, p < 0.001; Jordan = 26.93 ± 13.7 vs. 23.37 ± 15.2, p < 0.001; depression: Syria = 26.53 ± 12.6 vs. 22.93 ± 12.2, p < 0.001; Jordan = 17.70 ± 11.0 vs. 15.76 ± 11.1, p = 0.049). No significant improvements were evident for control group participants from either countries.

Conclusion: Prevalence of anxiety/depression for females with PCOS living in Syria and in Jordan is high and calls for special attention by healthcare specialists and policymakers in both countries. Females, who received the PCOS pharmaceutical care service, showed significant improvements in anxiety/depression scores. Improvements were similar in both countries.

Keywords: Anxiety; Depression; Lifestyle modifications and pharmacist; Polycystic ovary syndrome; War.