Discussion
anxiety, PCOS, depressive, PCOSStrengths, depression
SECONDARY, DISORDERS
This study demonstrates that participation in a supervised 12-week HIIT intervention leads to a reduction in depression, anxiety and stress scores in overweight women with PCOS, with MICT also significantly improving stress scores. Both HIIT and MICT resulted in improvements in multiple domains of both general and PCOS specific HRQoL.It is well-established that women with PCOS display a higher prevalence of anxiety and depression disorders compared to women without PCOSExercise intensity can elicit different neural responses and may influence the effect on depressive symptoms, however, the exact mechanisms are unclearWomen with PCOS display reductions in HRQoL compared to women without PCOSStrengths of this study include the randomised design and the work-matched interventions. We would like to acknowledge there are some limitations to this study. As this study is a secondary analysis, it was not designed to be powered to detect significant changes between groups in mental health and HRQoL outcomes. Future exercise interventions comparing exercise intensities that have been designed to detect changes in mental health outcomes are required to confirm these findings. It could also be considered a limitation that we did not include a non-exercise control group, however, we would like to highlight the numerous robust studies that have shown that exercise, compared to an inactive control group, improves the symptoms of PCOS, and therefore the aim of this study was to compare the two exercise intensities. We recommend that future studies also include a follow-up period to determine whether HIIT is sustainable post-intervention and to determine whether the improvements observed here are maintained long-term. Lastly, as many women were ineligible due to use of hormonal contraceptives, it is important that future studies examine the impact of HIIT in all women with PCOS regardless of medication use.In conclusion, we found improvements in depression, anxiety and stress scores after HIIT, and reduced stress scores after MICT. Both exercise interventions resulted in improvements in multiple domain scores of HRQoL suggesting that exercise intensity may be less important for improving HRQoL. Although evidence from this study highlights the potential of HIIT for improving symptoms of mental health, further investigation into the benefits of HIIT compared to MICT for improving mental health and HRQoL outcomes in women with PCOS is warranted.