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Fernández MDM, Saulyte J, Inskip HM, Takkouche B. Premenstrual syndrome and alcohol consumption: a systematic review and meta-analysis. BMJ Open 2018; 8:e019490. [PMID: 29661913 PMCID: PMC5905748 DOI: 10.1136/bmjopen-2017-019490] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/13/2017] [Accepted: 02/09/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Premenstrual syndrome (PMS) is a very common disorder worldwide which carries an important economic burden. We conducted a systematic review and a meta-analysis to assess the role of alcohol in the occurrence of PMS. METHODS We searched MEDLINE, EMBASE, the five regional bibliographic databases of the WHO, the Proceedings database and the Open Access Thesis and Dissertations (OATD) from inception to May 2017. We also reviewed the references of every article retrieved and established personal contact with researchers to trace further publications or reports. We did not include any language limitations. Studies were included if: (1) they presented original data from cohort, case-control or cross-sectional studies, (2) PMS was clearly defined as the outcome of interest, (3) one of the exposure factors was alcohol consumption, (4) they provided estimates of odds ratios, relative risks, or any other effect measure and their confidence intervals, or enough data to calculate them. RESULTS We identified 39 studies of which 19 were eligible. Intake of alcohol was associated with a moderate increase in the risk of PMS (OR=1.45, 95% CI: 1.17 to 1.79). Heavy drinking yielded a larger increase in the risk than any drinking (OR=1.79, 95% CI: 1.39 to 2.32). DISCUSSION Our results suggest that alcohol intake presents a moderate association with PMS risk. Future studies should avoid cross-sectional designs and focus on determining whether there is a threshold of alcohol intake under which the harmful effect on PMS is non-existent.
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Affiliation(s)
- María del Mar Fernández
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Jurgita Saulyte
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
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Symptom Attributions Across the Menstrual Cycle in Women with Panic Disorder. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2018. [DOI: 10.1007/s10942-018-0288-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nillni YI, Pineles SL, Rohan KJ, Zvolensky MJ, Rasmusson AM. The influence of the menstrual cycle on reactivity to a CO 2 challenge among women with and without premenstrual symptoms. Cogn Behav Ther 2016; 46:239-249. [PMID: 27687294 DOI: 10.1080/16506073.2016.1236286] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Clinically significant premenstrual symptoms (PMS) is conceptualized as a depressive disorder in DSM-5, however, it may share pathophysiological processes with anxiety- and fear-related disorders. Specifically, women with PMS panic at higher rates during biological challenge procedures. It is unclear if this increased interoceptive sensitivity is a general vulnerability or specific to the premenstrual phase. The current study examined the role of menstrual cycle phase on reactivity to a CO2 challenge among women with (n = 11) and without (n = 26) clinically significant PMS (N = 37). During the late follicular phase (days 6-12), women with and without PMS responded similarly to the CO2 challenge, whereas during the premenstrual phase (within 5 days before menses), women with PMS reported significantly more intense panic symptoms in response to the challenge than women without PMS. Vulnerability to panic in women with PMS may be specific to the premenstrual phase. Potential psychological and neurobiological mechanisms underlying this phenomenon are discussed.
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Affiliation(s)
- Yael I Nillni
- a Women's Health Sciences Division, National Center for PTSD , VA Boston Healthcare System , Boston , MA , USA.,b Department of Psychiatry , Boston University School of Medicine , Boston , MA , USA
| | - Suzanne L Pineles
- a Women's Health Sciences Division, National Center for PTSD , VA Boston Healthcare System , Boston , MA , USA.,b Department of Psychiatry , Boston University School of Medicine , Boston , MA , USA
| | | | - Michael J Zvolensky
- d University of Houston , Houston , TX , USA.,e The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Ann M Rasmusson
- a Women's Health Sciences Division, National Center for PTSD , VA Boston Healthcare System , Boston , MA , USA.,b Department of Psychiatry , Boston University School of Medicine , Boston , MA , USA
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Lifestyle Behaviours Add to the Armoury of Treatment Options for Panic Disorder: An Evidence-Based Reasoning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7017-43. [PMID: 26095868 PMCID: PMC4483746 DOI: 10.3390/ijerph120607017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/16/2022]
Abstract
This article presents an evidence-based reasoning, focusing on evidence of an Occupational Therapy input to lifestyle behaviour influences on panic disorder that also provides potentially broader application across other mental health problems (MHP). The article begins from the premise that we are all different. It then follows through a sequence of questions, examining incrementally how MHPs are experienced and classified. It analyses the impact of individual sensitivity at different levels of analysis, from genetic and epigenetic individuality, through neurotransmitter and body system sensitivity. Examples are given demonstrating the evidence base behind the logical sequence of investigation. The paper considers the evidence of how everyday routine lifestyle behaviour impacts on occupational function at all levels, and how these behaviours link to individual sensitivity to influence the level of exposure required to elicit symptomatic responses. Occupational Therapists can help patients by adequately assessing individual sensitivity, and through promoting understanding and a sense of control over their own symptoms. It concludes that present clinical guidelines should be expanded to incorporate knowledge of individual sensitivities to environmental exposures and lifestyle behaviours at an early stage.
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López-Solà C, Fontenelle LF, Alonso P, Cuadras D, Foley DL, Pantelis C, Pujol J, Yücel M, Cardoner N, Soriano-Mas C, Menchón JM, Harrison BJ. Prevalence and heritability of obsessive-compulsive spectrum and anxiety disorder symptoms: A survey of the Australian Twin Registry. Am J Med Genet B Neuropsychiatr Genet 2014; 165B:314-25. [PMID: 24756981 DOI: 10.1002/ajmg.b.32233] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 03/26/2014] [Indexed: 01/04/2023]
Abstract
While past twin studies indicate moderate levels of heritability of "obsessive-compulsive related" and anxiety disorder symptoms, no single study has reported such estimates in the same twin population nor examined potential genetic sex differences. We assessed symptoms of obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, hypochondriasis, panic disorder, social phobia and generalized anxiety disorder in 2,495 adult twins (1,468 female). Prevalence estimates for the corresponding symptom measures were determined using empirically derived cut-off scores. Twin resemblance was assessed by Pearson correlations and biometrical model-fitting analyses, incorporating sex-specific effects, using OpenMx. Prevalence estimates ranged from 1.6% in the symptoms of generalized anxiety to 16.9% for social phobia. Female twins demonstrated significantly higher prevalence rates across all domains with the exception of obsessive-compulsive symptoms. Additive genetic factors accounted for a moderate proportion of the total liability to each symptom domain. Evidence suggesting qualitative genetic sex differences (i.e., distinct genetic influences between genders) was observed for body dysmorphic concern and panic symptoms, while quantitative differences were observed for hoarding and social phobia symptoms, indicating stronger heritability in females. Novel findings in this study include the observation of probable genetic sex differences in liability towards hoarding symptoms and dysmorphic concern, as well as the lack of such differences in hypochondriasis. The trend towards qualitative sex differences in panic symptoms has some intuitive appeal with regard to biological-experimental models of panic.
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Affiliation(s)
- Clara López-Solà
- Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
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Nillni YI, Berenz EC, Pineles SL, Coffey SF, Zvolensky MJ. Anxiety Sensitivity as a Moderator of the Association Between Premenstrual Symptoms and Posttraumatic Stress Disorder Symptom Severity. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2014; 6:167-175. [PMID: 26973758 DOI: 10.1037/a0032087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Experience of premenstrual symptoms may be an important factor involved in understanding posttraumatic stress disorder (PTSD) symptom vulnerability. Correlations between PTSD and premenstrual dysphoric disorder (PMDD) have been identified in epidemiological studies, however, the nature of this relation is not clear. The current study examined the incremental validity of premenstrual symptoms, as well as their interaction with anxiety sensitivity, in the prediction of PTSD symptom severity above and beyond other theoretically relevant covariates. A community sample of trauma-exposed women (N = 63) completed questionnaires assessing premenstrual symptoms, anxiety sensitivity, and neuroticism and were administered the Clinician-Administered PTSD Scale to assess PTSD symptom severity. A series of hierarchical linear regressions revealed that premenstrual symptoms uniquely predicted PTSD total, reexperiencing, avoidance, and hyperarousal symptoms above and beyond other theoretically relevant covariates (i.e., number of potentially traumatic events, neuroticism, panic attack history, and anxiety sensitivity). Additionally, anxiety sensitivity emerged as a moderator of the association between premenstrual symptoms and PTSD symptom severity such that greater premenstrual symptoms were associated with greater PTSD total, reexperiencing, and numbing symptom severity for individuals high, but not low, in anxiety sensitivity. Experience of premenstrual symptoms may be an important sex-specific mechanism involved in increasing vulnerability for PTSD symptoms, particularly among women high in anxiety sensitivity.
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Affiliation(s)
- Yael I Nillni
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, and Boston University School of Medicine
| | - Erin C Berenz
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | - Suzanne L Pineles
- National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, Boston, Massachusetts and Boston University School of Medicine
| | - Scott F Coffey
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
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The role of menstrual cycle phase and anxiety sensitivity in catastrophic misinterpretation of physical symptoms during a CO(2) challenge. Arch Womens Ment Health 2012; 15:413-22. [PMID: 22923028 PMCID: PMC3495998 DOI: 10.1007/s00737-012-0302-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 08/07/2012] [Indexed: 10/28/2022]
Abstract
The current study examined the interactive effects of anxiety sensitivity (AS; fear of anxiety and anxiety-related sensations) and menstrual cycle phase (premenstrual phase vs. follicular phase) on panic-relevant responding (i.e., cognitive and physical panic symptoms, subjective anxiety, and skin conductance level). Women completed a baseline session and underwent a 3-min 10 % CO(2)-enriched air biological challenge paradigm during her premenstrual and follicular menstrual cycle phases. Participants were 55 women with no current or past history of panic disorder recruited from the general community (M (age) = 26.18, SD = 8.9) who completed the biological challenge during both the premenstrual and follicular cycle phases. Results revealed that women higher on AS demonstrated increased cognitive panic symptoms in response to the challenge during the premenstrual phase as compared to the follicular phase, and as compared to women lower on AS assessed in either cycle phase. However, the interaction of AS and menstrual cycle phase did not significantly predict physical panic attack symptoms, subjective ratings of anxiety, or skin conductance level in response to the challenge. Results are discussed in the context of premenstrual exacerbations of cognitive, as opposed to physical, panic attack symptoms for high AS women, and the clinical implications of these findings.
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Bunaciu L, Feldner MT, Babson KA, Zvolensky MJ, Eifert GH. Biological sex and panic-relevant anxious reactivity to abrupt increases in bodily arousal as a function of biological challenge intensity. J Behav Ther Exp Psychiatry 2012; 43:526-31. [PMID: 21813084 DOI: 10.1016/j.jbtep.2011.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 01/21/2011] [Accepted: 07/01/2011] [Indexed: 11/29/2022]
Abstract
An emerging pattern of results from panic-relevant biological challenge studies suggests women respond with greater subjective anxiety than men, but only to relatively abrupt and intense challenge procedures. The current investigation examined the relation between biological sex and self-reported anxious reactivity following biological challenges of varying durations and intensity. Participants were 285 (152 females; M(age) = 21.38; SD = 5.92) nonclinical adults who completed one of three protocols: a 3-min voluntary hyperventilation challenge (VH), a 5-min 10% carbon dioxide-enriched air (CO(2)) challenge, or a 25-s 20% CO(2) challenge. As predicted, results indicated that the 20% CO(2) challenge elicited greater self-reported anxiety than the VH and 10% CO(2) challenges. Moreover, women endorsed greater anxious reactivity than men, but only following the 20% CO(2) challenge. Results are discussed in terms of processes likely to account for sex differences in anxious reactivity following relatively abrupt and intense biological challenges.
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Affiliation(s)
- Liviu Bunaciu
- Intervention Sciences Laboratory, University of Arkansas, Department of Psychology, 216 Memorial Hall, Fayetteville, AR 72701, USA.
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Nillni YI, Berenz EC, Rohan KJ, Zvolensky MJ. Sex differences in panic-relevant responding to a 10% carbon dioxide-enriched air biological challenge. J Anxiety Disord 2012; 26:165-72. [PMID: 22115836 PMCID: PMC3254702 DOI: 10.1016/j.janxdis.2011.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Revised: 10/27/2011] [Accepted: 10/30/2011] [Indexed: 10/15/2022]
Abstract
The current study examined sex differences in psychological (i.e., self-reported anxiety, panic symptoms, and avoidance) and physiological (i.e., heart rate and skin conductance level) response to, and recovery from, a laboratory biological challenge. Participants were a community-recruited sample of 128 adults (63.3% women; M(age)=23.2 years, SD=8.9) who underwent a 4-min 10% CO(2)-enriched air biological challenge. As predicted, women reported more severe physical panic symptoms and avoidance (i.e., less willingness to participate in another challenge) and demonstrated increased heart rate as compared to men above and beyond the variance accounted for by other theoretically relevant variables (recent panic attack history, neuroticism, and anxiety sensitivity). Additionally, women demonstrated a faster rate of recovery with respect to heart rate compared to men. These results are in line with literature documenting sex-specific differences in panic psychopathology, and results are discussed in the context of possible mechanisms underlying sex differences in panic vulnerability.
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Affiliation(s)
- Yael I. Nillni
- University of Vermont, Department of Psychology, 2 Colchester Ave., Burlington, VT 05405,Corresponding author: Yael I. Nillni; Address: John Dewey Hall, 2 Colchester Ave., Burlington, VT 05405; phone: (781) 413-6319; Fax: (802) 656-8783;
| | - Erin C. Berenz
- Virginia Commonwealth University, 800 East Leigh Street, Biotech One, PO Box 980126, Richmond, VA 23298
| | - Kelly J. Rohan
- University of Vermont, Department of Psychology, 2 Colchester Ave., Burlington, VT 05405
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology, 126 Heyne Building, Houston, TX 77204
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