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Kubica C, Ketelhut S, Nigg CR. Polarized running training adapted to versus contrary to the menstrual cycle phases has similar effects on endurance performance and cardiovascular parameters. Eur J Appl Physiol 2024:10.1007/s00421-024-05545-9. [PMID: 38977510 DOI: 10.1007/s00421-024-05545-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/16/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE This study compared the effects of polarized running training adapted to the menstrual cycle (MC) phases versus polarized training adapted contrary to the MC on endurance performance and cardiovascular parameters. METHODS Thirty-three naturally menstruating, moderately trained females (age: 26 ± 4 years; BMI: 22.3 ± 3.2 kg/m2; V ˙ O2max/rel: 40.35 ± 4.61 ml/min/kg) were randomly assigned to a control (CON) and intervention (INT) group. Both groups participated in a load-matched eight-week running training intervention. In the INT, high-intensity sessions were aligned with the mid and late follicular phase, low-intensity sessions with the early and mid-luteal phase, and recovery with the late luteal and early follicular phase. In the CON, high-intensity sessions were matched to the late luteal and early follicular phase, and recovery to the mid and late follicular phase. Endurance performance and cardiovascular parameters were assessed at baseline and after the intervention. RESULTS Twenty-six females completed the intervention. A repeated measures ANOVA determined no time × group interaction effect for any parameter. A significant time effect was found for maximal oxygen uptake (F(1,12) = 18.753, p = 0.005, ηp2 = 0.630), the velocity at the ventilatory threshold one (F(1,12) = 10.704, p = 0.007, ηp2 = 0.493) and two (F(1,12) = 7.746, p = .018, ηp2 = .413). CONCLUSION The training intervention improved endurance performance in both groups, with no further benefit observed from the MC-adapted polarized training in a group-based analysis. Replications with an extended intervention period, a larger sample size, and a more reliable MC determination are warranted.
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Affiliation(s)
- Claudia Kubica
- Health Science Department, University of Bern, Bern, Switzerland.
| | - Sascha Ketelhut
- Health Science Department, University of Bern, Bern, Switzerland
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2
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Haußmann J, Goeckenjan M, Haußmann R, Wimberger P. [Premenstrual syndrome and premenstrual dysphoric disorder-Overview on pathophysiology, diagnostics and treatment]. DER NERVENARZT 2024; 95:268-274. [PMID: 38393358 PMCID: PMC10914875 DOI: 10.1007/s00115-024-01625-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
Premenstrual syndrome and premenstrual dysphoric disorder become episodically manifest during the second half of the female menstrual cycle and are characterized by psychological and physical symptoms causing relevant functional and social impairments. Mood swings, depression and dysphoria are associated depressive symptoms. Therefore, affective disorders should be considered as a differential diagnosis. Of women in reproductive age 3-8% suffer from premenstrual syndrome and 2% of women are affected by premenstrual dysphoric disorder. Genetic and sociobiographical risk factors are discussed. Furthermore, genetic polymorphisms of specific hormone receptors are considered to be genetic risk factors. From a pathophysiological perspective premenstrual syndrome and premenstrual dysphoric disorder are caused by a complex interaction between cyclic changes of ovarian steroids and central neurotransmitters. An imbalance of estrogen and progesterone in the luteal phase is believed to cause the symptoms. Therefore, the first treatment approach consists of regulation of the menstrual cycle or luteal support with progesterone or synthetic progestins even if their effectiveness has not yet been proven in randomized controlled studies and meta-analyses. The administration of combined oral contraceptives is also an option. Especially treatment with selective serotonin reuptake inhibitors (SSRI) represent an evidence-based approach. In severe cases the administration of gonadotropin releasing hormone (GnRH) agonists with add back treatment can also be considered. In the field of affective disorders premenstrual syndromes represent clinically relevant differential diagnoses and comorbidities, which confront the treating physician with particular clinical challenges. Therefore, this literature review gives the readership a clinical orientation for dealing with these disorders.
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Affiliation(s)
- Jana Haußmann
- Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - M Goeckenjan
- Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - R Haußmann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - P Wimberger
- Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
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Nayman S, Schricker IF, Reinhard I, Kuehner C. Childhood adversity predicts stronger premenstrual mood worsening, stress appraisal and cortisol decrease in women with Premenstrual Dysphoric Disorder. Front Endocrinol (Lausanne) 2023; 14:1278531. [PMID: 38027112 PMCID: PMC10653441 DOI: 10.3389/fendo.2023.1278531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Lifetime traumatic events are prevalent in women with Premenstrual Dysphoric Disorder (PMDD) and predict stronger premenstrual symptom intensities. Less is known about the unique effects of childhood adversity on PMDD. This study aims to investigate the menstrual cycle related course of mood, stress appraisal and cortisol activity over time and the effects of childhood adversity - by controlling for recent stressful life events - on the cyclicity of these outcomes. Methods Fifty-two women with PMDD completed questionnaires on childhood adversity and stressful life events during the past 12 months. Momentary negative and positive affect, stress appraisal, and saliva-cortisol were assessed within an Ambulatory Assessment (AA) design over four consecutive days during both the follicular and the late luteal phase. This AA was repeated after five months, resulting in two measurement bursts. Results Women with PMDD showed expected cycle related variations in mood and stress appraisal, whereby these effects weakened over time. No cortisol cyclicity was identified. Higher childhood adversity was linked to stronger increases in negative affect and stress appraisal, and stronger decreases in positive affect from the follicular toward the late luteal phase. Women with higher childhood adversity exhibited lower cortisol levels during the late luteal phase compared to the follicular phase whereas no such cyclicity was found in women with lower childhood adversity. Conclusion Childhood adversity appears to show independent deteriorating effects on premenstrual mood worsening and stress appraisal in women with PMDD. The observed cortisol cyclicity in women with higher childhood adversity may point to different neuroendocrine subtypes of PMDD in relation to childhood trauma and requires further systematic research.
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Affiliation(s)
- Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Blaser BL, Weymar M, Wendt J. [Efficient assessment of premenstrual symptoms - German translation of the shortened Premenstrual Assessment Form and its psychometric evaluation]. Psychother Psychosom Med Psychol 2023; 73:405-412. [PMID: 37619601 PMCID: PMC10777709 DOI: 10.1055/a-2136-6941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/15/2023] [Indexed: 08/26/2023]
Abstract
Premenstrual symptomatology is a widespread and yet under-researched problem. To date, there is no German instrument for assessing the broad spectrum of possible symptoms and their degree of expression. For this reason, the short versions of the Premenstrual Assessment Form with 20 and 10 items were translated and validated in a sample of N=147 menstruating persons. The internal consistencies of the 20-item and 10-item versions are high (Cronbach's αPAF20=0.93 and αPAF10=0.88, respectively) and comparable to the original versions. Factor analysis identified two scales that assess psychological and physiological symptoms. Convergent validity was demonstrated by a correlation with the PMS Impact Questionnaire (rPAF20=0.66, p<.001). This association was significantly higher (z=2.67, p=0.004) than the correlation with the Brief Symptom Inventory-18 (rPAF20=0.50, p<0.001), which verifies divergent validity. Additionally, cut-off values for suspected diagnoses based on DSM-V diagnostic criteria for both short forms were calculated. The translated Premenstrual Assessment Form is a valid, reliable, and parsimonious instrument that can be used flexibly. It is suitable for quantifying premenstrual symptomatology in research.
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Affiliation(s)
| | | | - Julia Wendt
- Emotions- und Biopsychologie, Universität Potsdam
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Nayman S, Konstantinow DT, Schricker IF, Reinhard I, Kuehner C. Associations of premenstrual symptoms with daily rumination and perceived stress and the moderating effects of mindfulness facets on symptom cyclicity in premenstrual syndrome. Arch Womens Ment Health 2023; 26:167-176. [PMID: 36899192 PMCID: PMC10063513 DOI: 10.1007/s00737-023-01304-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/04/2023] [Indexed: 03/12/2023]
Abstract
Subthreshold premenstrual symptoms can be impairing even if the diagnostic criteria for premenstrual dysphoric disorder (PMDD) are not reached. Previous research suggests shared psychological risk factors without a clear differentiation of premenstrual syndrome (PMS) from PMDD. This study focuses on a sample with a wide range of premenstrual symptoms not reaching PMDD-criteria and aims to investigate within-person associations of premenstrual symptoms with daily rumination and perceived stress during the late luteal phase as well as cycle-phase specific associations of habitual mindfulness including present-moment-awareness and acceptance with premenstrual symptoms and impairment. Fifty-six naturally cycling women with self-reported premenstrual symptoms completed an online diary on premenstrual symptoms, rumination and perceived stress over two consecutive menstrual cycles, and baseline questionnaires on habitual present-moment-awareness and acceptance. Multilevel analyses revealed cycle-related variations in premenstrual symptoms and impairment (all ps < .001). Higher within-person levels of core and secondary premenstrual symptoms during the late luteal phase predicted increased daily rumination and perceived stress (all ps < .001) and increased somatic symptoms predicted increased rumination (p ≤ .018). Higher habitual present-moment-awareness was linked to lower premenstrual symptom and impairment levels toward the late luteal phase whereas higher habitual acceptance was associated with lower premenstrual functional impairment (p ≤ .015). Premenstrual symptom increases during the late luteal phase in women with PMS seem to be linked to increased daily rumination and perceived stress. Trait present-moment-awareness and acceptance in turn seem to reflect protective factors against premenstrual distress and may represent useful targets for interventions.
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Affiliation(s)
- Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Desiree Tina Konstantinow
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
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Takeda T. Premenstrual disorders: Premenstrual syndrome and premenstrual dysphoric disorder. J Obstet Gynaecol Res 2023; 49:510-518. [PMID: 36317488 DOI: 10.1111/jog.15484] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/20/2022] [Indexed: 02/10/2023]
Abstract
Recently, the term premenstrual disorders (PMDs), which includes premenstrual syndrome and premenstrual dysphoric disorder as a continuum, has been proposed. Although the precise etiology of PMDs remains unknown, the involvement of hormonal fluctuations is clear. The brain transmitters, serotonin and γ-amino butyric acid, also seem to be involved. Serotonin reuptake inhibitors and oral contraceptives are the current mainstay of treatment, but these are insufficient. Even the currently used prospective two-period symptom diary is not widely used in actual clinical practice, creating a major problem of discrepancy between research and clinical practice. In this review, I would like to outline the latest information and problems in the etiology, diagnosis, and treatment of PMDs, with an emphasis on promising new therapies.
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Affiliation(s)
- Takashi Takeda
- Division of Women's Health, Research Institute of Traditional Asian Medicine, Kindai University School of Medicine, Osaka, Japan
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Kimmig ACS, Wildgruber D, Gärtner A, Drotleff B, Krylova M, Lämmerhofer M, Sundström-Poromaa I, Derntl B. Lower affective empathy in oral contraceptive users: a cross-sectional fMRI study. Cereb Cortex 2022; 33:4319-4333. [PMID: 36137568 DOI: 10.1093/cercor/bhac345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 01/10/2023] Open
Abstract
Evidence accumulates that oral contraceptive (OC) use modulates various socio-affective behaviors, including empathic abilities. Endogenous and synthetic sex hormones, such as estrogens and progestogens, bind to receptor sites in brain regions (i.e. frontal, limbic, and cerebellar) involved in socio-affective processing. Therefore, the aim of this study was to investigate the role of OC use in empathy. In a cross-sectional functional magnetic resonance imaging study, women in different hormonal states, including OC use (n = 46) or being naturally cycling in the early follicular (fNC: n = 37) or peri-ovulatory phase (oNC: n = 28), performed a visual, sentence-based empathy task. Behaviorally, OC users had lower empathy ratings than oNC women. Congruently, whole-brain analysis revealed significantly larger task-related activation of several brain regions, including the left dorsomedial prefrontal gyrus (dmPFG), left precentral gyrus, and left temporoparietal junction in oNC compared to OC women. In OC users, the activity of the left dmPFG and precentral gyrus was negatively associated with behavioral and self-reported affective empathy. Furthermore, empathy-related region-of-interest analysis indicated negative associations of brain activation with synthetic hormone levels in OC women. Overall, this multimodal, cross-sectional investigation of empathy suggests a role of OC intake in especially affective empathy and highlights the importance of including synthetic hormone levels in OC-related analyses.
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Affiliation(s)
- Ann-Christin Sophie Kimmig
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.,Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Ottfried-Müller-Str. 27, 72076 Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Anna Gärtner
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Bernhard Drotleff
- Department of Pharmacy and Biochemistry, Institute of Pharmaceutical Sciences, Pharmaceutical (Bio-)Analysis, University of Tübingen, Auf der Morgenstelle 8, 72076 Tübingen, Germany
| | - Marina Krylova
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany.,Department of Radiology, Institute of Diagnostic and Interventional Radiology, Medical Physics Group, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany
| | - Michael Lämmerhofer
- Department of Pharmacy and Biochemistry, Institute of Pharmaceutical Sciences, Pharmaceutical (Bio-)Analysis, University of Tübingen, Auf der Morgenstelle 8, 72076 Tübingen, Germany
| | - Inger Sundström-Poromaa
- Department of Women's and Children's Health, University of Uppsala, Akademiska sjukhuset, 751 85 Uppsala, Sweden
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.,LEAD Graduate School & Research Network, University of Tübingen, Europastraße 6, 72072 Tübingen Germany
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8
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Premenstrual Syndrome: The Role of Emotion Regulation Strategies and Trait Meta-Mood. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021. [DOI: 10.1007/s10942-021-00412-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Kimmig ACS, Wildgruber D, Wendel SMU, Sundström-Poromaa I, Derntl B. Friend vs. Foe: Cognitive and Affective Empathy in Women With Different Hormonal States. Front Neurosci 2021; 15:608768. [PMID: 33762905 PMCID: PMC7982725 DOI: 10.3389/fnins.2021.608768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/09/2021] [Indexed: 01/10/2023] Open
Abstract
Empathy is crucial for social functioning as well as social coherence. It can be influenced by modulatory factors such as familiarity and liking (i.e., emotional closeness). Furthermore, there are first hints that hormonal status may modulate affective but not cognitive empathy in women. The aim of this study was to investigate potential separate as well as combined modulatory effects of emotional closeness and hormonal status on female cognitive and affective empathy. Three hormonal status groups of women (n = 62) were studied: (1) naturally-cycling (NC) women in the early follicular phase (fNC), (2) NC women during periovulatory phase (oNC), and (3) oral contraceptive (OC) users. All women underwent a newly developed empathy task (i.e., Tübinger Empathy Test, TET) presenting textual descriptions of positive and negative emotional scenes relating to three different perspectives (i.e., self vs. friend vs. enemy/disliked person). Regardless of hormonal status, empathic responses were higher for the friend compared to the enemy perspective for both empathy components. However, cognitive empathy was less affected by varying emotional closeness toward the target person than affective empathy. Hormonal status modulated only affective empathy. OC users showed significantly less affective empathy toward the enemy compared to the fNC women. Overall, affective empathy seems more sensitive to modulatory effects of emotional closeness and hormonal status than cognitive empathy. Possible implications of this current investigation for future research on empathy and OC use, contraceptive education as well as for other clinical applications are discussed.
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Affiliation(s)
- Ann-Christin Sophie Kimmig
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tübingen, Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Sina-Maria Ute Wendel
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | | | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tübingen, Tübingen, Germany.,Tübingen Neuro Campus, University of Tübingen, Tübingen, Germany
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10
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Mahfoud Z, Emam R, Anchassi D, Omran S, Alhaj N, Al-Abdulla S, El-Amin A, Shehata M, Aly S, Al Emadi N, Al-Meer F, Al-Amin H. Premenstrual dysphoric disorder in Arab women: Validation and cultural adaptation of the Arabic version of the premenstrual screening tool. Women Health 2018; 59:631-645. [PMID: 30475684 DOI: 10.1080/03630242.2018.1539433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Premenstrual dysphoric disorder (PMDD) is not well-studied in Arab populations. The goal of this study was to validate the Arabic version of the Premenstrual Symptoms Screening Tool (PSST) using the DSM diagnosis of PMDD as the gold standard. The PSST was translated and culturally adapted using back translation and the approval of the original author. We recruited 194 adult women (between October 2013 and March 2014) from two primary care centers in Doha, Qatar. A psychiatrist determined the diagnosis using the semi-structured Mini International Neuropsychiatric Interview, and another rater blinded to the diagnosis finalized the Arabic PSST and administered other clinical questionnaires. The data showed that premenstrual symptoms and PMDD were observed in about 37 percent and 15 percent, respectively, of the women enrolled. The mean age of the women with PMDD according to the PSST was about 30 years, and the majority had children. The Arabic PSST showed high specificity of 95.6 percent but low sensitivity of 26.7 percent. A factor analysis of the different items in Arabic PSST showed that the Arabic PSST could detect the cases with definite PMDD and thus can be a useful tool in primary care settings as this treatable disorder is underdiagnosed in the Arab populations.
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Affiliation(s)
- Ziyad Mahfoud
- a Department of Global and Public Health , Weill Cornell Medicine in Qatar , Doha , Qatar.,b Department of Healthcare Policy and Research , Weill Cornell Medicine , New York , New York , USA
| | - Rana Emam
- c Weill Cornell Medicine in Qatar , Doha , Qatar
| | | | | | - Najlaa Alhaj
- d Department of Psychiatry , Hamad Medical Corporation , Doha , Qatar
| | | | - Ahmed El-Amin
- d Department of Psychiatry , Hamad Medical Corporation , Doha , Qatar
| | - Mena Shehata
- d Department of Psychiatry , Hamad Medical Corporation , Doha , Qatar
| | - Shereene Aly
- d Department of Psychiatry , Hamad Medical Corporation , Doha , Qatar
| | | | | | - Hassen Al-Amin
- f Department of Psychiatry , Weill Cornell Medicine in Qatar , Doha , Qatar
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11
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Schmidt K, Weber N, Steiner M, Meyer N, Dubberke A, Rutenberg D, Hellhammer J. A lecithin phosphatidylserine and phosphatidic acid complex (PAS) reduces symptoms of the premenstrual syndrome (PMS): Results of a randomized, placebo-controlled, double-blind clinical trial. Clin Nutr ESPEN 2018; 24:22-30. [PMID: 29576358 DOI: 10.1016/j.clnesp.2018.01.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 12/07/2017] [Accepted: 01/22/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Many women experience emotional and physical symptoms around the time of ovulation and more so before menstruation interfering with their daily normal life also known as premenstrual syndrome (PMS). Recent observational data suggest that supplementation with Lipogen's phosphatidylserine (PS) and phosphatidic acid (PA) complex (PAS) alleviates these PMS symptoms. The aim of this study was to confirm these observations on the effects of PAS on PMS symptom severity within a controlled clinical trial setting. METHODS Forty women aged 18-45 years with a diagnosis of PMS were assigned to either take PAS (containing 400 mg PS & 400 mg PA per day) or a matching placebo. The study comprised 5 on-site visits including 1 baseline menstrual cycle followed by 3 treatment cycles. Treatment intake was controlled for by using an electronic device, the Medication Event Monitoring System (MEMS®). Primary outcome of the study was the PMS symptoms severity as assessed by using the Daily Record of Severity of Problems (DRSP). Further, SIPS questionnaire (a German version of the Premenstrual Symptoms Screening Tool (PSST)), salivary hormone levels (cortisol awakening response (CAR) and evening cortisol levels) as well as serum levels (cortisol, estradiol, progesterone and corticosteroid binding globulin (CBG)) were assessed. RESULTS PMS symptoms as assessed by the DRSP Total score showed a significantly better improvement (p = 0.001) over a 3 cycles PAS intake as compared to placebo. In addition, PAS treated women reported a greater improvement in physical (p = 0.002) and depressive symptoms (p = 0.068). They also reported a lower reduction of productivity (p = 0.052) and a stronger decrease in interference with relationships with others (p = 0.099) compared to the placebo group. No other DRSP scale or item showed significant results. Likewise, the reduction in the number of subjects fulfilling PMS or premenstrual dysphoric disorder (PMDD) criteria as classified by the SIPS did not differ between the PAS and the placebo group. For the biomarkers, the salivary cortisol percentage increase of the CAR was significantly less pronounced in the follicular phase of cycle 4 than in the follicular phase of cycle 1 for subjects taking PAS when compared to subjects taking placebo (p = 0.018). Furthermore, the change of serum cortisol levels between visit 1 and visit 5 differed significantly between groups (p = 0.043). While serum cortisol levels of PAS treated females slightly decreased between visit 1 and visit 5, cortisol levels of females treated with placebo increased. For all other biomarkers, no treatment effects were observed over the 4 cycles study period. Overall, this study confirms that a daily intake of PAS, containing 400 mg PS and 400 mg PA, can be considered as safe. CONCLUSIONS Results substantiate the efficacy of PAS in reducing symptoms of PMS. In view of the recent inclusion of severe PMS symptoms (PMDD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the positive results of this clinical study merits consideration of developing the PAS complex as a botanical drug for treatment of PMDD. CLINICAL TRIAL REGISTRATION The study is registered at Deutsches Register Klinischer Studien with the registration number DRKS00009005.
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Affiliation(s)
| | - Nicole Weber
- Contract Research Institute daacro, Trier, Germany
| | - Meir Steiner
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada; Department of Obstetrics & Gynecology, McMaster University, Hamilton, Canada
| | - Nadin Meyer
- Contract Research Institute daacro, Trier, Germany
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Henz A, Ferreira CF, Oderich CL, Gallon CW, Castro JRSD, Conzatti M, Fleck MPDA, Wender MCO. Premenstrual Syndrome Diagnosis: A Comparative Study between the Daily Record of Severity of Problems (DRSP) and the Premenstrual Symptoms Screening Tool (PSST). REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2018; 40:20-25. [PMID: 29132173 PMCID: PMC10467366 DOI: 10.1055/s-0037-1608672] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 10/05/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To validate the premenstrual symptoms screening tool (PSST) in relation to the daily record of severity of problems (DRSP) for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) diagnoses. METHODS A cross-sectional study with 127 women (20-45 years) with PMS complaints. The women were evaluated in terms of weight, height and body mass index (BMI). After using the primary care evaluation of mental disorders (PRIME-MD) questionnaire to exclude the diagnosis of depression, the PSST was completed and the women were instructed to fill out the DRSP for two consecutive menstrual cycles. The agreement between the two questionnaires was assessed by the Kappa (k) and the prevalence-adjusted, bias-adjusted kappa (PABAK) values. RESULTS Two-hundred and eighty-two women met the eligibility criteria and answered the PSST. The DRSP was completed for two cycles by 127 women. The percentages of women with PMS and PMDD diagnoses by the DRSP were 74.8% and 3.9% respectively; by PSST, the percentages were41.7% and 34.6% respectively. The number of patients considered "normal" (with symptoms below the threshold for the diagnosis of PMS) was similar in both questionnaires. There was no agreement (Kappa = 0.12) in the results of PMS/ PMDD diagnosis (the PABAK coefficient confirmed this result = 0.39). The PSST had a high sensitivity (79%) and a low specificity (33.3%) for PMS/PMDD diagnosis. CONCLUSION The PSST should be considered a diagnostic screening tool. Positive PMS/PMDD cases by PSST should be further evaluated by DRSP to confirm the diagnosis.
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Affiliation(s)
- Aline Henz
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | - Maiara Conzatti
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Stute P, Bodmer C, Ehlert U, Eltbogen R, Ging A, Streuli I, von Wolff M. Interdisciplinary consensus on management of premenstrual disorders in Switzerland. Gynecol Endocrinol 2017; 33:342-348. [PMID: 28277114 DOI: 10.1080/09513590.2017.1284788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Premenstrual disorders (PMD) can affect women throughout their entire reproductive years. In 2016, an interdisciplinary expert meeting of general gynecologists, gynecological endocrinologists, psychiatrists and psychologists from Switzerland was held to provide an interdisciplinary algorithm on PMD management taking reproductive stages into account. The Swiss PMD algorithm differentiates between primary and secondary PMD care providers incorporating different levels of diagnostic and treatment. Treatment options include cognitive behavioral therapy, alternative therapy, antidepressants, ovulation suppression and diuretics. Treatment choice depends on prevalent PMD symptoms, (reproductive) age, family planning, cardiovascular risk factors, comorbidities, comedication and the woman's preference. Regular follow-ups are mandatory.
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Affiliation(s)
- Petra Stute
- a Department of Obstetrics and Gynecology , Inselspital, University of Bern , Bern , Switzerland
| | - Christine Bodmer
- b Office for Women's Health, Bethesda Spital , Basel , Switzerland
| | - Ulrike Ehlert
- c Institute for Psychology, UZH , Zürich , Switzerland
| | - Roger Eltbogen
- d Swiss Society for Phytotherapy, SMGP , Grüental, Wädenswil , Switzerland
| | - Ankica Ging
- e Psychiatry and Psychotherapy, University of Bern , Bern , Switzerland , and
| | - Isabelle Streuli
- f Unité de médecine de la reproduction et d'endocrinologie gynécologique, HUG , Genève , Geneva , Switzerland
| | - Michael von Wolff
- a Department of Obstetrics and Gynecology , Inselspital, University of Bern , Bern , Switzerland
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Reuveni I, Dan R, Segman R, Evron R, Laufer S, Goelman G, Bonne O, Canetti L. Emotional regulation difficulties and premenstrual symptoms among Israeli students. Arch Womens Ment Health 2016; 19:1063-1070. [PMID: 27538401 DOI: 10.1007/s00737-016-0656-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 08/12/2016] [Indexed: 12/21/2022]
Abstract
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) reported to affect 3-8 % of women of reproductive age and resulting in marked emotional and occupational impairment. Despite its prevalence, the etiology of PMDD is largely unknown, and patients remain mostly undiagnosed and poorly treated. It has been suggested that PMDD is a manifestation of underlying depressive disorder which is associated with the inability to regulate emotions in an adaptive manner. Therefore, we hypothesized that women with PMDD would exhibit increased difficulty with emotional regulation. A total of 648 female Israeli college students were assessed by the Premenstrual Symptoms Screening Tool (PSST) and the Difficulties in Emotion Regulation Scale (DERS). Of these women, 166 (25.6 %) met the criteria for PMS. Sixty-four (9.9 %) suffered from PMDD. More emotion regulation deficits were observed in the PMDD and PMS groups compared to the control group. Furthermore, there were more emotional regulation deficits among the predominantly psychological and mixed symptom subtype compared to the predominantly physical symptom subtype group. This is the first study to report an association between emotional dysregulation and PMDD. These findings may lead to development of more individually tailored treatment protocols focused on improving emotional regulation techniques.
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Affiliation(s)
- Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Rotem Dan
- MRI/MRS Lab, The Human Biology Research Center, Department of Medical Biophysics, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Edmond and Lily Safra Center for Brain Sciences (ELSC), The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronen Segman
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ron Evron
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Sofia Laufer
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Gadi Goelman
- MRI/MRS Lab, The Human Biology Research Center, Department of Medical Biophysics, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Omer Bonne
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Laura Canetti
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Jerusalem, Israel.,Department of Psychology, Hebrew University, Jerusalem, Israel
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Câmara RDA, Köhler CA, Frey BN, Hyphantis TN, Carvalho AF. Validation of the Brazilian Portuguese version of the Premenstrual Symptoms Screening Tool (PSST) and association of PSST scores with health-related quality of life. ACTA ACUST UNITED AC 2016; 39:140-146. [PMID: 27901212 PMCID: PMC7111450 DOI: 10.1590/1516-4446-2016-1953] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/12/2016] [Indexed: 12/18/2022]
Abstract
Objective: To develop and validate a Brazilian Portuguese version of the Premenstrual Symptoms Screening Tool (PSST), a questionnaire used for the screening of premenstrual syndrome (PMS) and of the most severe form of PMS, premenstrual dysphoric disorder (PMDD). The PSST also rates the impact of premenstrual symptoms on daily activities. Methods: A consecutive sample of 801 women aged ≥ 18 years completed the study protocol. The internal consistency, test-retest reliability, and content validity of the Brazilian PSST were determined. The independent association of a positive screen for PMS or PMDD and quality of life determined by the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) was also assessed. Results: Of 801 participants, 132 (16.5%) had a positive screening for PMDD. The Brazilian PSST had adequate internal consistency (Cronbach's alpha = 0.91) and test-retest reliability. The PSST also had adequate convergent/discriminant validity, without redundancy. Content validity ratio and content validity index were 0.61 and 0.94 respectively. Finally, a positive screen for PMS/PMDD was associated with worse WHOQOL-Bref scores. Conclusions: These findings suggest that PSST is a reliable and valid instrument to screen for PMS/PMDD in Brazilian women.
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Affiliation(s)
- Rachel de A Câmara
- Departamento de Clínica Médica e Grupo de Pesquisa em Psiquiatria Translacional, Faculdade de Medicina, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
| | - Cristiano A Köhler
- Departamento de Clínica Médica e Grupo de Pesquisa em Psiquiatria Translacional, Faculdade de Medicina, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
| | - Benicio N Frey
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Thomas N Hyphantis
- Department of Psychiatry, Division of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - André F Carvalho
- Departamento de Clínica Médica e Grupo de Pesquisa em Psiquiatria Translacional, Faculdade de Medicina, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
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Janda C, Kues JN, Andersson G, Kleinstäuber M, Weise C. A symptom diary to assess severe premenstrual syndrome and premenstrual dysphoric disorder. Women Health 2016; 57:837-854. [PMID: 27355449 DOI: 10.1080/03630242.2016.1206055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The differentiation between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) has been widely discussed. PMDD is listed as a mental disorder in the DSM-5, whereas PMS is not considered as a mental disorder in any diagnostic manual. Consequently, PMS is operationalized in different ways. Keeping a symptom diary is required to diagnose PMDD but is also recommended for PMS. The aim of our study was, therefore, to operationalize PMS and PMDD within a DSM-5-based symptom diary. We developed a symptom-intensity-score (SI-score) and an interference-score (INT-score) to evaluate the symptom diary. Ninety-eight women (aged 20-45 years) completed a symptom diary over two menstrual cycles, a retrospective screening for premenstrual symptoms, and answered additional impairment questionnaires from August 2013 to August 2015. The scores revealed moderate to good reliability (Cronbach's α = 0.83-0.96). Convergent validity was shown by significant correlations with a retrospective screening, the Pain Disability Index, and the German PMS-Impact Questionnaire. Discriminant validity was indicated by low correlations with the Big Five Inventory-10. These scores may facilitate the evaluation of prospective symptom ratings in research and clinical practice. Future research should focus on continuing to validate the scores (e.g., in an ambulatory setting).
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Affiliation(s)
- Carolyn Janda
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps University , Marburg , Germany
| | - Johanna N Kues
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps University , Marburg , Germany
| | - Gerhard Andersson
- b Linnaeus Centre HEAD, Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden.,c Department of Clinical Neuroscience, Psychiatry Section , Karolinska Institutet , Stockholm , Sweden
| | - Maria Kleinstäuber
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps University , Marburg , Germany
| | - Cornelia Weise
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps University , Marburg , Germany.,b Linnaeus Centre HEAD, Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden
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Kues JN, Janda C, Kleinstäuber M, Weise C. How to measure the impact of premenstrual symptoms? Development and validation of the German PMS-Impact Questionnaire. Women Health 2015; 56:807-26. [PMID: 26624615 DOI: 10.1080/03630242.2015.1118734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
With 75% of women of reproductive age affected, premenstrual symptoms are very common, ranging from emotional and cognitive to physical symptoms. Premenstrual Syndrome and Premenstrual Dysphoric Disorder can lead to substantial functional interference and psychological distress comparable to that of dysthymic disorders. The assessment of this impact is required as a part of the diagnostic procedure in the DSM-5. In the absence of a specific measure, the authors developed the PMS-Impact Questionnaire. A sample of 101 women reporting severe premenstrual complaints was assessed with the twenty-two items in the questionnaire during their premenstrual phase in an ongoing intervention study at the Philipps-University Marburg from August 2013 until January 2015. An exploratory factor analysis revealed a two-factor solution (labeled Psychological Impact and Functional Impact) with 18 items. A Cronbach's alpha of 0.90 for Psychological Impact and of 0.90 for Functional Impact indicated good reliability. Convergent construct validity was demonstrated by moderate to high correlations with the Pain Disability Index. Low correlations with the Big Five Inventory-10 indicated good divergent validity. The PMS-Impact Questionnaire was found to be a valid, reliable, and an economic measure to assess the impact of premenstrual symptoms. In future research, cross validations and confirmatory factor analyses should be conducted.
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Affiliation(s)
- Johanna N Kues
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-University of Marburg , Marburg , Germany
| | - Carolyn Janda
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-University of Marburg , Marburg , Germany
| | - Maria Kleinstäuber
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-University of Marburg , Marburg , Germany
| | - Cornelia Weise
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-University of Marburg , Marburg , Germany.,b Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD , Linköping University , Linköping , Sweden
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Janda C, Kues JN, Kleinstäuber M, Weise C. Wie kann man den Umgang mit prämenstruellen Symptomen verändern? Ein modularisiertes Behandlungsprogramm. VERHALTENSTHERAPIE 2015. [DOI: 10.1159/000439336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hoyer J, Burmann I, Kieseler ML, Vollrath F, Hellrung L, Arelin K, Roggenhofer E, Villringer A, Sacher J. Menstrual cycle phase modulates emotional conflict processing in women with and without premenstrual syndrome (PMS)--a pilot study. PLoS One 2013; 8:e59780. [PMID: 23637739 PMCID: PMC3634788 DOI: 10.1371/journal.pone.0059780] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 02/18/2013] [Indexed: 12/21/2022] Open
Abstract
Background Premenstrual syndrome (PMS) is characterized by a cluster of psychological and somatic symptoms during the late luteal phase of the menstrual cycle that disappear after the onset of menses. Behavioral differences in emotional and cognitive processing have been reported in women with PMS, and it is of particular interest whether PMS affects the parallel execution of emotional and cognitive processing. Related to this is the question of how the performance of women with PMS relates to stress levels compared to women without PMS. Cortisol has been shown to affect emotional processing in general and it has also been shown that women with severe PMS have a particular cortisol profile. Methods We measured performance in an emotional conflict task and stress levels in women with PMS (n = 15) and women without PMS (n = 15) throughout their menstrual cycle. Results We found a significant increase (p = 0.001) in the mean reaction time for resolving emotional conflict from the follicular to the luteal cycle phase in all subjects. Only women with PMS demonstrated an increase in physiological and subjective stress measures during the luteal menstrual cycle phase. Conclusions Our findings suggest that the menstrual cycle modulates the integration of emotional and cognitive processing in all women. Preliminary data are supportive of the secondary hypothesis that stress levels are mediated by the menstrual cycle phase only in women with PMS. The presented evidence for menstrual cycle-specific differences in integrating emotional and cognitive information highlights the importance of controlling for menstrual cycle phase in studies that aim to elucidate the interplay of emotion and cognition.
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Affiliation(s)
- Jana Hoyer
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Inga Burmann
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Marie-Luise Kieseler
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Florian Vollrath
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lydia Hellrung
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Katrin Arelin
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Elisabeth Roggenhofer
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Arno Villringer
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
| | - Julia Sacher
- Department of Cognitive Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Hospital Leipzig, University of Leipzig, Leipzig, Germany
- * E-mail:
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Forrester-Knauss C, Zemp Stutz E, Weiss C, Tschudin S. The interrelation between premenstrual syndrome and major depression: results from a population-based sample. BMC Public Health 2011; 11:795. [PMID: 21992230 PMCID: PMC3209462 DOI: 10.1186/1471-2458-11-795] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 10/12/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research about the relationship between premenstrual syndrome (PMS) and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. The objectives of the study were to assess the association between premenstrual syndrome and major depression, to analyse how PMS and major depression differ and to characterise the group of women who report both PMS and major depression. METHODS Data were obtained from the Swiss Health Survey 2007. Included in the analysis was data from women under the age of 55 without hysterectomy and who answered the questions on PMS symptoms. The population-based sample consisted of 3518 women. Weighted prevalence rates were calculated and relative risk ratios for PMS, major depression and women who reported both PMS and major depression, were calculated with logistic multinominal logit regression. RESULTS The prevalence of major depression was 11.3% in women screening positive for moderate PMS and 24.6% in women screening positive for severe PMS. Compared to women without any of these conditions, women who reported moderate to severe alcohol consumption had a lower risk for PMS. Women reporting use of antidepressants, and use of oral contraceptives had a higher risk for major depression compared to women without any of these conditions. Women reporting work dissatisfaction had a higher risk for PMS. A higher relative risk to report both PMS and major depression compared to women without PMS or major depression was related to factors such as high psychological distress, low mastery, psychotropic drug consumption, and low self-rated health. CONCLUSIONS The results suggested that women who suffer from both PMS and major depression are more impaired compared to women with only one disorder. The results further indicated that PMS and major depression are different disorders that can, however, co-occur.
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Affiliation(s)
- Christine Forrester-Knauss
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), Socinstr, 57, 4051 Basel, Switzerland.
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