# Determinants of Health-Related Quality of Life in Women with Turner Syndrome: The Role of Comorbidities, Hormonal Therapy and Depressive Symptoms

## TL;DR

This study explores how comorbidities, hormonal therapy, and depression affect the quality of life in women with Turner syndrome.

## Contribution

The study identifies specific factors influencing health-related quality of life in Turner syndrome patients through a comprehensive analysis.

## Key findings

- Women with Turner syndrome had lower scores in general health, vitality, social functioning, and mental health compared to controls.
- Depressive symptoms and comorbidity burden were significant negative predictors of quality of life.
- Hearing impairment and final height were also associated with quality of life outcomes.

## Abstract

Background: Turner syndrome (TS) is a chromosomal disorder associated with considerable phenotypic variability and lifelong multisystem comorbidities. Beyond somatic manifestations, TS may substantially affect physical, psychological, and social functioning, highlighting the need for comprehensive assessment of quality of life in affected women. Methods: This observational comparative study included 30 adult women with genetically confirmed Turner syndrome and 43 age-matched healthy controls. Quality of life was assessed using the SF-36 questionnaire, with clinical, anthropometric, and psychosocial variables analyzed as potential predictors using correlation and multivariable regression analyses. Results: Women with Turner syndrome were significantly shorter than controls and more frequently affected by hypothyroidism, cardiac defects, and hearing impairment. They scored lower on SF-36 domains of general health, vitality, social functioning, and mental health, while exhibiting higher BDI-II depressive symptoms. Quality of life correlated negatively with comorbidity burden and depressive symptoms, positively with final height, and was lower in patients with hearing impairment, highlighting the multifactorial determinants of well-being in TS. Conclusions: Health-related quality of life in women with Turner syndrome is shaped by a complex interplay of somatic burden, psychological well-being, and social functioning. Depressive symptoms, comorbidities, stature, and hearing impairment significantly influence outcomes, emphasizing the need for holistic, multidisciplinary care that extends beyond medical management.