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    Role of hyperandrogenism on disordered eating behaviors in adolescents with PCOS and interplay with insulin resistance
    (Walter De Gruyter Gmbh, 2026) Kaymaz, Nazan; Kara, Ozlem; Sirin, Hande; Kasap, Tolga; Uzun, Mehmet Erdem
    Objectives: This study examines the roles of hyperandrogenism (HA) and insulin resistance (IR) in eating behaviors among adolescents with polycystic ovary syndrome (PCOS). Methods: Fifty adolescents with PCOS (mean age 16.04 +/- 1.46 years, BMI 27.55 +/- 6.34) were assessed. IR was evaluated using HOMA-IR, and eating behaviors were measured with the Eating Attitudes Test (EAT) and the Eating Disorders Examination Questionnaire (EDE-Q). Results: IR was present in 46 % of participants, with obesity affecting 71 % of those with IR. While EAT scores showed no significant association with BMI, HA, or IR, the IR group had higher EDE-Q Total scores (p=0.05), particularly in Shape Concern (SC, p=0.003) and Weight Concern (WC, p=0.03). HA primarily influenced WC (p=0.04). BMI correlated more strongly with WC (r=0.579, p<0.001) than IR. ROC analysis indicated BMI>27.5 (AUC=0.967) and HOMA-IR>3.1 (AUC=0.961) as strong predictors of disordered eating. Conclusions: BMI and HOMA-IR are more reliable than HA for identifying disordered eating behaviors in PCOS adolescents. The EDE-Q is recommended for effective screening, emphasizing the need to monitor BMI and HOMA-IR in this population.
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    The effect of hyperandrogenism and obesity on mindfulness and metacognition in adolescents with polycystic ovary syndrome
    (Springer Wien, 2022) Kara, Ozlem; Kaymaz, Nazan; Uzun, Mehmet Erdem
    The aim of this study was to determine whether serum androgen levels have an effect on mindfulness and metacognition in adolescents with polycystic ovary syndrome (PCOS). Adolescents diagnosed with PCOS were asked to answer a questionnaire that included socio-demographic information and two scales: the Mindful Attention Awareness Scale (MAAS) and the Metacognition Scale Child and Adolescent form (MCQ-C). The patients were divided into two groups, the hyperandrogenism group and the non-hyperandrogenism group, according to serum androgen levels. The scores of MAAS and MCQ-C were compared between the groups. The study sample consisted of 70 adolescents. Of these, 44 had hyperandrogenism according to a blood test. No statistically significant difference was found in MAAS scores between the hyperandrogenism and the non-hyperandrogenism groups (p = 0.79). However, the level of mindfulness was found to be lower in participants with a higher modified Ferriman-Gallwey score (mFGS) (r = 0.26, p = 0.02). Mindfulness levels were also lower for obese patients with PCOS compared to non-obese patients with PCOS (p = 0.02). Cognitive monitoring (MCQ-C-CM), one of the MCQ-C sub-scales, was significantly higher in the non-hyperandrogenism group (p = 0.03), and similarly, a positive correlation was detected between higher androgen levels and the positive meta-worry (MCQ-C-PM) sub-scale of the MCQ-C (for total testosterone; r = 0.348, p = 0.03, and for androstenedione; r = 0.35, p = 0.03). High serum androgen levels in PCOS had no effect on mindfulness, but as the modified Ferriman Gallwey score increased, mindfulness levels decreased. For the sub-scales of MCQ-C,MCQ-C-CM, and MCQ-C-PM, the scores increased as androgen levels increased. In line with the results of the present study, evaluating mindfulness in PCOS patients with increased hair growth and metacognition in PCOS patients with serum hyperandrogenism may contribute well-being in adulthood by reducing the psychological burden caused by the disease.
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    The Impact of BMI on Self-Concept in Adolescents with Pubertal Gynecomastia
    (Galenos Publ House, 2025) Kaymaz, Nazan; Kara, Ozlem; Kasap, Tolga; Uzun, Mehmet Erdem; Sirin, Hande
    Introduction: Physiological changes in the body may result in anxiety and impaired self-concept during adolescence. Although temporary, pubertal gynecomastia (PG) may cause negative emotions that interrupt the development of self-concept by causing a physical appearance that does not fit the male gender. This paper aimed to identify whether the self-concept level of adolescents with PG is moderated by their anthropometrics. Materials and Methods: This case-control study included adolescent males, with pubertal stage assessed using the Marshall and Tanner criteria. PG was diagnosed by palpation of a subareolar glandular disc. Anthropometric measurements were obtained by trained pediatric endocrinology clinic staff, and self-concept was evaluated using the Piers-Harris Children's Self-Concept Scale (PHCSCS). To specify relationships correlation and regression analysis were examined. Results: The study included 38 adolescents with PG and 61 age-and pubertal stage-matched controls. BMI was significantly higher in the PG group, and self-concept scores declined with increasing BMI (p=0.044; r=-0.437, p=0.006). PG subjects at Tanner Stage 3 were shorter than controls (p=0.03) and had lower happiness and behavior subscale scores (p=0.01; p=0.04). PG duration was negatively correlated with total self-concept (r=-0.400, p=0.013) and the subscales of happiness (r=- 0.456), behavior (r=-0.334), and physical appearance (r=-0.354). Conclusion: Adolescents with PG demonstrated lower self-concept, particularly in relation to higher BMI, shorter stature at mid-puberty, and prolonged symptom duration. These findings highlight the need for early psychosocial support in affected individuals.
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    The Impact of Lipomastia on Self-Esteem and Social Anxiety in Adolescents with Obesity
    (Canadian Acad Child & Adolescent Psychiatry, 2025) Kara, Ozlem; Kaymaz, Nazan; Sirin, Hande; Uzun, Mehmet Erdem
    Background: Obesity can negatively impact adolescents' self-esteem, and lipomastia can further complicate the situation. Objective: The current study endeavors to examine the influence of lipomastia on the levels of social anxiety and self-esteem in individuals with obesity. Methods: Seventy adolescent male outpatients with obesity completed a form of demographics, the SAS-A (Social Anxiety Scale for Adolescents), and the Rosenberg Self-Esteem Scale (RSES-10 item). Participants were stratified according to the presence of lipomastia, and correlation analyses were conducted to investigate the association between social anxiety and self-esteem in relation to lipomastia. Results: No significant difference was found between the lipomastia and non-lipomastia groups regarding self-esteem. While the lipomastia group had slightly higher overall social anxiety scores, significant differences were noted only in fear of negative evaluation. There was no relationship between the SAS-A total score and anthropometric measurements in both groups. However, a negative relationship was observed between self-esteem and anthropometric measurements in the lipomastia group, whereas such a relationship was not observed in the control group. Conclusion: Adolescents with lipomastia showed higher social anxiety, particularly fear of negative evaluation, despite similar demographic and anthropometric characteristics to their peers. Higher BMI correlated with lower self-esteem, highlighting the complex interplay between body image, self-esteem, and social anxiety. These findings underscore the need for targeted interventions to support adolescents with obesity and lipomastia.