The Association Between Polycystic Ovary Syndrome (PCOS) and Depression in Saudi Women: Cross-Sectional Study

Background: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age, with a notably high prevalence in Saudi Arabia (20-25%). Emerging evidence suggests a strong association between PCOS and depression, yet limited research has explored this relationship in Saudi women. Objective: This study aimed to investigate the association between PCOS and depression in Saudi women, assessing prevalence, severity, and demographic predictors. Methods: A cross-sectional study was conducted among 654 Saudi women aged 18–45, recruited via online platforms across major cities. PCOS diagnosis was confirmed using Rotterdam Criteria, and depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Descriptive statistics, chi-square tests, and logistic regression were used for analysis. Results: PCOS prevalence was 27.5%, with irregular menstruation (42.2%) and weight gain (35.8%) as the most common symptoms. Depression (PHQ-9 ≥10) was significantly higher in women with PCOS (46.7%) compared to those without (26.6%, p < 0.001). The mean PHQ-9 score was markedly elevated in the PCOS group (9.8 ± 4.9 vs. 6.2 ± 3.5, p < 0.001), with PCOS nearly doubling depression risk (OR = 2.45, 95% CI: 1.72–3.49). Divorced/widowed women had the highest rates of PCOS (36.7%) and depression (43.3%), followed by unemployed participants (37.1%). Conclusion: PCOS is strongly associated with depression in Saudi women, particularly among those facing marital instability or unemployment. These findings highlight the need for integrated mental health screening and psychosocial support for women with PCOS in Saudi Arabia. Future research should explore longitudinal causality and targeted interventions.