title: Predictive factors of health-related quality of life in patients with polycystic ovary syndrome: a structural equation modeling approach.
abstract: OBJECTIVE
  To determine association between health-related quality of life (HRQOL) and psychosexual variables in patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Two private gynecology clinics.
  
  
  METHODS
  A sample of 300 women with PCOS were entered into the study and were subdivided into three groups: hyperandrogenism (HA) and PCO morphology; menstrual dysfunction and PCO morphology; menstrual dysfunction and HA and/or PCO morphology. Then each patient completed the following questionnaires: the Hospital Anxiety and Depression Scale, the Body Image Concern Inventory, the Rosenberg Self-Esteem Scale, the Short-Form Health Survey, and the Female Sexual Function Index.
  
  
  METHODS
  None.
  
  
  METHODS
  Both direct and indirect relationships among clinical symptoms, psychologic status, self-esteem, body image, and sexual function as independent predictors of HRQOL were examined with the use of structural equation modeling analysis.
  
  
  RESULTS
  The clinical variables and psychologic distress had the strongest indirect relationships with HRQOL in the HA phenotype. The highest effect of PCOS symptoms on HRQOL impairment in patients with menstrual irregularities along with HA and patients with menstrual irregularities along with polycystic ovaries was exerted by clinical variables, poor perception of self-worth, negative body image, and sexual dysfunction.
  
  
  CONCLUSIONS
  In patients with various phenotypes of PCOS, the effects of mediating variables on HRQOL are different. In patients with PCOS, the findings suggest that mediating factors, especially psychologic distress, self-esteem, body image, and sexual function, play an important role and should be taken into consideration and adequately treated if present.
authors.affiliation: Reproductive Health and Midwifery Department, Tarbiat Modares University, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Bazarganipour
authors.forename: Saeide
authors.initials: S
authors.lastname: Ziaei
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Foroozanfard
authors.forename: Anoshirvan
authors.initials: A
authors.lastname: Kazemnejad
authors.forename: Soghrat
authors.initials: S
authors.lastname: Faghihzadeh
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001828:Body Image; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000175:diagnosis / Q000523:psychology; D007492:Iran; D008597:Menstrual Cycle; D008599:Menstruation Disturbances / Q000175:diagnosis / Q000523:psychology; D008603:Mental Health; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D011237:Predictive Value of Tests; D011788:Quality of Life; D012649:Self Concept; D012720:Severity of Illness Index; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Health-related quality of life; Iran; polycystic ovary syndrome; structural equation modeling