Objectives:
To assess attachment patterns and stress coping strategies in patients with NIH and non-NIH phenotypes of PCOS. Additionally, to explore the correlations between attachment and stress coping, as well as the correlations between BMI, hirsutism, and psychological variables.

Methods:
62 patients with NIH phenotypes and 32 patients with non-NIH phenotypes were enrolled into the study. Each patient underwent gynecological and endocrinological diagnostics. Attachment Styles Questionnaire was used to assess attachment, and Mini-Cope Inventory was applied to assess stress coping.

Results:
The anxious-ambivalent attachment pattern was more pronounced in patients with “classic” NIH phenotypes. Patients with NIH phenotypes were less likely to use active coping, planning, and acceptance as coping mechanisms for stress. Furthermore, we observed a statistical trend in the differences in the following avoidance coping strategies: denial (p = 0.066), behavioral disengagement (p = 0.084), and self-blame (p = 0.066). In both phenotypes secure attachment correlated positively with seeking emotional support, whereas anxious-avoidant correlated negatively with this mechanism. In turn, anxious-ambivalent attachment in both phenotypes correlated negatively with acceptance and positively with behavioral disengagement and self-blame. Attachment patterns did not correlate with either BMI or the severity of hirsutism.

Conclusions:
Patients with different PCOS phenotypes differ in their attachment patterns and stress coping strategies. Attachment styles are correlated with specific coping mechanisms for stress. Personalized approach that takes into account the clinical variability of PCOS and differences in psychological functioning should be applied.