Abstract
Purpose: Changes in facial emotion processing were examined over the course of anti-androgen treatment in women with PCOS. We also explored whether these changes in emotion processing correlated with changes in mood and anxiety symptoms over treatment.
Methods: Thirty-three women with PCOS received 12 weeks of naturalistic treatment based on clinical presentation. Facial emotion processing was assessed at baseline and 12-weeks on the Reading the Mind in the Eyes Test, and a computerised Facial Expression Recognition (FER) Task, which measured accuracy and response time in recognising facial expressions (happiness, sadness, fear, disgust, anger, neutral), and neutral misinterpretation bias. The Hospital Anxiety and Depression Scale was completed at the same time-points. Outcomes were compared with a control group of 40 healthy women.
Results: Women with PCOS (mean age = 29 years) were treated with a variety of medications, mainly spironolactone (n = 22) and oral contraceptives (n = 16). Within the PCOS group, significant improvement was found for 10 of 19 FER variables over treatment, and in depression and anxiety symptoms. When comparing the PCOS and control groups over time, the PCOS group became significantly faster in responding to disgusted and neutral expressions, and reduced in their tendency to misinterpret neutral faces as angry. Improved depression and anxiety symptoms correlated significantly with improved accuracy in recognising fearful expressions, but not with any other FER variables.
Conclusions: In this preliminary study, anti-androgen treatment improved some aspects of facial emotion processing in women with PCOS, which has implications for understanding the mental health aspects of PCOS.