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Hou L, Meng Y, Gao J, Li M, Zhou R. Women with more severe premenstrual syndrome have an enhanced anticipatory reward processing: a magnetoencephalography study. Arch Womens Ment Health 2023; 26:803-817. [PMID: 37730923 DOI: 10.1007/s00737-023-01368-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Laboratory studies reveal that young women with premenstrual syndrome (PMS) often exhibit decreased reward processing during the late luteal phase. However, studies based on the self-reports find opposite results (e.g., higher craving for high-sweet-fat food). These differences may lie in the difference between the stimulus used and measuring the different aspects of the reward. The present study was designed to expand previous work by using a classic monetary reward paradigm, simultaneously examining the motivational (i.e., reward anticipation, "wanting") and emotional (i.e., reward outcome, "liking") components of reward processing in women with high premenstrual symptoms (High PMS). College female students in their early twenties with High PMS (n = 20) and low premenstrual symptoms (Low PMS, n = 20) completed a monetary incentive delay task during their late luteal phase when the premenstrual symptoms typically peak. Brain activities in the reward anticipation phase and outcome phase were recorded using the magnetoencephalographic (MEG) imaging technique. No group differences were found in various behavioral measurements. For the MEG results, in the anticipation phase, when High PMS participants were presented with cues that predicted the upcoming monetary gains, they showed higher event-related magnetic fields (ERFs) than when they were presented with neutral non-reward cues. This pattern was reversed in Low PMS participants, as they showed lower reward cue-elicited ERFs than non-reward cue-elicited ones (cluster mass = 2560, cluster size = 891, p = .03, corrected for multiple comparisons), mainly in the right medial orbitofrontal and lateral orbitofrontal cortex (cluster mass = 375, cluster size = 140, p = .03, corrected for multiple comparisons). More importantly, women with High PMS had an overall significantly higher level of ERFs than women with Low PMS (cluster mass = 8039, cluster size = 2937, p = .0009, corrected for multiple comparisons) in the bilateral precentral gyrus, right postcentral gyrus, and left superior temporal gyrus (right: cluster mass = 410, cluster size = 128, p = .03; left: cluster mass = 352, cluster size = 98, p = .05; corrected for multiple comparisons). In the outcome phase, women with High PMS showed significantly lower theta power than the Low PMS ones for the expected non-reward feedback in the bilateral temporal-parietal regions (cluster mass = 47620, cluster size = 18308, p = .01, corrected for multiple comparisons). These findings reveal that the severity of PMS might alter reward anticipation. Specifically, women with High PMS displayed increased brain activities to reward-predicting cues and increased action preparation after the cues appear.
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Affiliation(s)
- Lulu Hou
- Department of Psychology, Nanjing University, Nanjing, 210023, China
- Department of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Yao Meng
- Department of Psychology, Nanjing University, Nanjing, 210023, China
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Jiahong Gao
- Beijing City Key Lab for Medical Physics and Engineering, Institution of Heavy Ion Physics, School of Physics, Peking University, Beijing, 100871, China
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
- McGovern Institute for Brain Research, Peking University, Beijing, 100871, China
| | - Ming Li
- Department of Psychology, Nanjing University, Nanjing, 210023, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing, 210023, China.
- Department of Radiology, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China.
- State Key Laboratory of Media Convergence Production Technology and Systems, Beijing, 100803, China.
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Li L, Lv X, Li Y, Zhang X, Li M, Cao Y. Development and validation of risk prediction model for premenstrual syndrome in nurses: results from the nurses-based the TARGET cohort study. Front Public Health 2023; 11:1203280. [PMID: 37854248 PMCID: PMC10579606 DOI: 10.3389/fpubh.2023.1203280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023] Open
Abstract
Objective Premenstrual syndrome (PMS) stands as a significant concern within the realm gynecological disorders, profoundly impacting women of childbearing age in China. However, the elusive nature of its risk factors necessitates investigation. This study, therefore, is dedicated to unraveling the intricacies of PMS by focusing on nurses, a cohort with unique occupational stressors, to develop and validate a predictive model for assessing the risk of PMS. Methods This investigation employed a multi-center cross-sectional analysis drawing upon data from the TARGET Nurses' health cohort. Utilizing online survey versions of the Premenstrual Syndrome Scale (PMSS), a comprehensive dataset encompassing physiological, social, psychological, occupational, and behavioral variables was collected from 18,645 participants. A stepwise multivariate logistic regression analysis was conducted to identify independent risk factors for PMS. Furthermore, a refined variable selection process was executed, combining the Least Absolute Shrinkage and Selection Operator (LASSO) method with 10-fold cross-validation. The visualization of the risk prediction model was achieved through a nomogram, and its performance was evaluated using the C index, receiver operating characteristic (ROC) curves, and the calibration curves. Results Among the diverse variables explored, this study identified several noteworthy predictors of PMS in nurses, including tea or coffee consumption, sleep quality, menstrual cycle regularity, intermenstrual bleeding episodes, dysmenorrhea severity, experiences of workplace bullying, trait coping style, anxiety, depression and perceived stress levels. The prediction model exhibited robust discriminatory power, with an area under the curve of 0.765 for the training set and 0.769 for the test set. Furthermore, the calibration curve underscored the model's high degree of alignment with observed outcomes. Conclusion The developed model showcases exceptional accuracy in identifying nurses at risk of PMS. This early alert system holds potential to significantly enhance nurses' well-being and underscore the importance of professional support.
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Affiliation(s)
- Li Li
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaoyan Lv
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuxin Li
- Department of Neonatology, Shandong Provincial Hospital, Jinan, China
| | - Xinyue Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mengli Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yingjuan Cao
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Nursing Theory and Practice Innovation Research Center, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Xing J, Wu H, Wang X, Yi S, Wei Y, Zhao Y, Hu X. Psychological, physiological, and biochemical correlations after negative emotional videos in college students with and without premenstrual syndrome. Front Psychiatry 2023; 14:1228276. [PMID: 37649559 PMCID: PMC10463732 DOI: 10.3389/fpsyt.2023.1228276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
Introduction Women with premenstrual syndrome (PMS) suffer heavily from emotional problems, the pathogenesis of which is believed to be related to the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system (ANS) and central nervous system (CNS). We took into account all 3 aspects to observed the psychological, physiological and biochemical correlations under anger and sadness in college students with and without PMS. Methods 33 students with PMS and 24 healthy students participated in the emotion induction experiment, and were required to fill out self-report scales. Their salivary cortisol (SCort), skin conductivity level (SCL), heart rate variability (HRV), blood pressure (BP) and electroencephalogram (EEG) data were collected at the resting stage and 10-15 minutes after each video. Results Compared to healthy controls, students with PMS showed lower SCort level and higher VLF at rest, and no statistic difference in activities of ANS and HPA axis after emotional videos, but different results in EEG in all conditions. The decreases in SBP during angry video, SCort after angry and neutral videos, and increases in θ band power during sad video were moderately correlated with increases in PMS score. No intergroup differences were found in self-report emotions. Discussion Students with PMS had lower activity of HPA axis and possibly higher activity of PNS at rest, and different response patterns in CNS in all conditions. Several EEG frequencies, especially θ band, in specific encephalic regions during emotional videos, as well as declined HPA activities in dealing with angry and neutral stressors, in which γ activity in frontal lobe may play a role, showed moderate correlations with more severe PMS.
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Affiliation(s)
- Jingyu Xing
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hao Wu
- Medical Department, Huguosi Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Xue Wang
- Chemical Industry Press Co., LTD, Beijing, China
| | - Shuang Yi
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Wei
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Yan Zhao
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xingang Hu
- Internal Encephalopathy of Traditional Chinese Medicine, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China
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Meng Y, Huang D, Hou L, Zhou R. Hypoactivation of autonomtic nervous system-related orbitofrontal and motor cortex during acute stress in women with premenstrual syndrome. Neurobiol Stress 2021; 15:100357. [PMID: 34258334 PMCID: PMC8252112 DOI: 10.1016/j.ynstr.2021.100357] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 10/25/2022] Open
Affiliation(s)
- Yao Meng
- Department of Psychology, Nanjing University, Nanjing, 210023, China.,School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Dejian Huang
- Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, 210028, China
| | - Lulu Hou
- Department of Psychology, Nanjing University, Nanjing, 210023, China.,Department of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing, 210023, China
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Hou L, Chang L, Chen L, Zhou R. Reduced Reward Responsiveness in Women With Moderate - to - Severe Premenstrual Syndrome: Evidence From a Probabilistic Reward Task. Front Psychiatry 2020; 11:28. [PMID: 32116845 PMCID: PMC7031199 DOI: 10.3389/fpsyt.2020.00028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 01/10/2020] [Indexed: 11/27/2022] Open
Abstract
Nearly 50% of women of reproductive age worldwide experience premenstrual syndrome (PMS). Women with PMS exhibit low positive affect and low frontal electroencephalography asymmetry scores, both of which are associated with reward processing. These findings suggest that women with PMS may exhibit deficiencies in reward processing. A probabilistic reward task based on signal detection approach was used to assess reward responsiveness in 30 women with moderate-to-severe PMS and 31 controls without PMS. The results revealed that in the late luteal phase, the women with moderate-to-severe PMS exhibited lower response bias and lower hit rate toward more frequently rewarded stimuli (rich stimuli) than the controls. By contrast, the response bias and hit rate did not differ between the two groups in the follicular phase. The group differences still remained after controlling for anhedonic symptoms. Furthermore, trial-by-trial probability analyses revealed that women with moderate-to-severe PMS exhibited a trend of having a higher miss rate for rich stimuli than the controls. In particular, when a rich stimulus was preceded by an infrequently rewarded stimulus (a rewarded lean stimulus), participants in the PMS group exhibited a trend for higher miss rate than those in the control group in the late luteal and follicular phases. However, group differences in the probability analyses were nonsignificant after controlling for anhedonic symptoms. These results provide preliminary evidence that women with moderate-to-severe PMS exhibit dysfunctional reward responsiveness and impaired ability to modulate their behavior as a function of prior reinforcement.
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Affiliation(s)
- Lulu Hou
- Department of Psychology, Nanjing University, Nanjing, China
| | - Lei Chang
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Lirong Chen
- Department of Psychology, Nanjing University, Nanjing, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing, China
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Abstract
Previous studies have revealed stress-induced dysregulation of hypothalamic-pituitary-adrenal (HPA) axis in women with premenstrual syndrome (PMS). So far, however, the results about the relationship between HPA axis dysregulation and PMS are mixed. To this end, it is necessary to investigate the basal activity of the HPA axis in women with PMS instead of only assessing a certain stressor. Therefore, this study evaluated the relationship between the cortisol awakening response (CAR) and PMS. Thirty-two women with PMS (mean age 22.47 ± 2.20 years) and 36 healthy controls (mean age 22.28 ± 2.43 years) were included in this study. Saliva samples of our participants were collected successively at 0, 30, 45, and 60 min after awakening to assess CAR during each of two phases of the menstrual cycle (the mid-follicular phase and the late luteal phase). The results showed a significantly attenuated CAR in women with PMS compared with the healthy controls, especially at 45 and 60 min after awakening, regardless of the menstrual cycle phases. Furthermore, there was a significant negative correlation between PMS severity as measured by PMS scale and AUCi (i.e. the Area Under the Curve with respect to increase) in the mid-follicular phase. Our findings suggested that an attenuated CAR activity profile may be an important risk factor for the development of PMS.
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Affiliation(s)
- Lulu Hou
- Department of Psychology, Nanjing University , Nanjing , China
| | - Yamei Huang
- Mental Health Education and Counseling Center, Beijing Institute of Fashion Technology , Beijing , China
| | - Renlai Zhou
- Department of Psychology, Nanjing University , Nanjing , China
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Armour M, Ee CC, Hao J, Wilson TM, Yao SS, Smith CA. Acupuncture and acupressure for premenstrual syndrome. Cochrane Database Syst Rev 2018; 8:CD005290. [PMID: 30105749 PMCID: PMC6513602 DOI: 10.1002/14651858.cd005290.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acupuncture has a history of traditional use in China for women's health conditions including premenstrual syndrome (PMS), but its effectiveness for this condition remains unclear. This review examined the available evidence supporting the use of acupuncture or acupressure to treat PMS. OBJECTIVES To evaluate the effectiveness and safety of acupuncture or acupressure for women with PMS or premenstrual dysphoric disorder (PMDD). SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Specialised Register, Cochrane Central Register of Studies Online (CENTRAL CRSO), MEDLINE, Embase, AMED, PsycINFO, CINAHL (from inception to 21 September 2017), two clinical trial databases (from their inception to 21 September 2017), and four electronic databases in China (from their inception to 15 October 2017): Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), VIP information/ Chinese Scientific Journals database and WANFANG. Reference lists from included articles were handsearched. SELECTION CRITERIA We included studies if they randomised women with PMS and associated disorders (PMDD and late luteal phase dysphoric disorder/LPDD) to receive acupuncture or acupressure versus sham, usual care/waiting-list control or pharmaceutical interventions mentioned by the International Society for Premenstrual Disorders (ISPMD). If acupuncture or acupressure were combined with another therapy, these studies were also included where the additional therapy was the same in both groups. Cross-over studies were eligible for inclusion, but only data from the first phase could be used. DATA COLLECTION AND ANALYSIS Two review authors independently selected the studies, assessed eligible studies for risk of bias, and extracted data from each study. Study authors were contacted for missing information. The quality of the evidence was assessed using GRADE. Our primary outcomes were overall premenstrual symptoms and adverse events. Secondary outcomes included specific PMS symptoms, response rate and quality of life. MAIN RESULTS Five trials (277 women) were included in this review. No trials compared acupuncture or acupressure versus other active treatments. The number of treatment sessions ranged from seven to 28. The quality of the evidence ranged from low to very low quality, the main limitations being imprecision due to small sample sizes and risk of bias related to detection bias and selective reporting.Acupuncture versus sham acupunctureAcupuncture may provide a greater reduction in mood-related PMS symptoms (mean difference (MD) -9.03, 95% confidence interval (CI) -10.71 to -7.35, one randomised controlled trial (RCT), n = 67, low-quality evidence) and in physical PMS symptoms (MD -9.11, 95% CI -10.82 to -7.40, one RCT, n = 67, low-quality evidence) than sham acupuncture, as measured by the Daily Record of Severity of Problems scale (DRSP). The evidence suggests that if women have a mood score of 51.91 points with sham acupuncture, their score with acupuncture would be between 10.71 and 7.35 points lower and if women have a physical score of 46.11 points, their score with acupuncture would be between 10.82 and 7.4 points lower.There was insufficient evidence to determine whether there was any difference between the groups in the rate of adverse events (risk ratio (RR) 1.74, 95% CI 0.39 to 7.76, three RCTs, n = 167, I2 = 0%, very low-quality evidence).Specific PMS symptoms were not reportedThere may be little or no difference between the groups in response rates. Use of a fixed-effect model suggested a higher response rate in the acupuncture group than in the sham group (RR 2.59, 95% CI 1.71 to 3.92; participants = 100; studies = 2; I2 = 82%), but owing to the high heterogeneity we tested the effect of using a random-effects model, which provided no clear evidence of benefit for acupuncture (RR 4.22, 95% CI 0.45 to 39.88, two RCTs, n = 100, I2 = 82%, very low-quality evidence).Acupuncture may improve quality of life (measured by the WHOQOL-BREF) compared to sham (MD 2.85, 95% CI 1.47 to 4.23, one RCT, n = 67, low-quality evidence).Acupuncture versus no treatmentDue to the very low quality of the evidence, we are uncertain whether acupuncture reduces PMS symptoms compared to a no treatment control (MD -13.60, 95% CI -15.70 to -11.50, one RCT, n = 14).No adverse events were reported in either group.No data were available on specific PMS symptoms, response rate or quality of life outcomes.Acupressure versus sham acupressureWe found low-quality evidence that acupressure may reduce the number of women with moderate to severe PMS symptoms at the end of the trial compared to sham acupressure (RR 0.64 95% CI 0.52 to 0.79, one RCT, n = 90, low-quality evidence). The evidence suggests that if 97 women out of 100 in the sham acupressure group had moderate to severe PMS symptoms, the number of women in the acupressure group with moderate to severe symptoms would be 50 to 76 women.Acupressure may improve both physical (MD 24.3, 95% CI 17.18 to 31.42, one RCT, n = 90, low-quality evidence) and mental (MD 17.17, 95% CI 13.08 to 21.26, one RCT, n = 90, low-quality evidence) quality of life.No data were available on adverse events, specific symptoms or response rates. AUTHORS' CONCLUSIONS The limited evidence available suggests that acupuncture and acupressure may improve both physical and psychological symptoms of PMS when compared to a sham control. There was insufficient evidence to determine whether there was a difference between the groups in rates of adverse events.There is no evidence comparing acupuncture or acupressure versus current ISPMD recommended treatments for PMS such as selective serotonin reuptake inhibitors (SSRIs). Further research is required, using validated outcome measures for PMS, adequate blinding and suitable comparator groups reflecting current best practice.
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Affiliation(s)
- Mike Armour
- Western Sydney UniversityNICM Health Research InstituteBuilding 5, Campbelltown CampusPenrithNSWAustralia2751
| | - Carolyn C Ee
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Building 5 Campbelltown CampusLocked Bag 1797PenrithNSWAustralia2751
| | - Jie Hao
- Western Sydney UniversitySchool of Science and HealthLocked Bag 1797PenrithSydneyNew South WalesAustralia2751
| | - Tanya Marie Wilson
- Atticus Health2104‐2106 Frankston‐Flinders RdHastingsVictoriaAustralia3915
| | - Sofia S Yao
- University of Western SydneySchool of Science and HealthNarellan Rd & Gilchrist DrCampbelltownAustralia2560
| | - Caroline A Smith
- Western Sydney UniversityNICM Health Research InstituteBuilding 5, Campbelltown CampusPenrithNSWAustralia2751
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Abstract
BACKGROUND Hormone level fluctuation across the menstrual cycle causes women to experience negative emotions and also affects their mood regulation and stress sensitivity. However, the stress reactivity and emotional variations in women with premenstrual syndrome (PMS), who are especially sensitive to the variations in hormone cycles, have not been explained. METHODS The present study used an electroencephalogram (EEG) stress evaluation test, a physiology stress evaluation test, and the positive affect and negative affect scale (PANAS) to evaluate the stress reactivity pattern and emotional state of women with PMS. RESULTS The results showed that women with PMS had higher negative affect and lower positive affect compared with controls. Moreover, under stressful conditions, the women with PMS had a higher alpha activity and a lower respiration rate than the controls. The differences in stress reactivity and emotional states between women with PMS and controls were based on a covariant analysis with menstrual cycle (luteal and follicular phases) as the covariate. CONCLUSION The results demonstrated that, compared with controls, women suffering from PMS have a continuous abnormality in emotional state and stress reactivity, which was independent of the menstrual cycle.
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Affiliation(s)
- Qing Liu
- Department of Nuclear Medicine and Medical PET Center, The Second Hospital of Zhejiang University School of Medicine, Zhejiang University, Hangzhou
| | - Yongshun Wang
- School of Physical Education and Sport, Huaqiao University, Xiamen, People’s Republic of China
| | | | - Wei Qiao
- Department of Physical Education, Xiamen Institute of Technology, Xiamen, People’s Republic of China
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Oxley T. The Feminism & Psychology Undergraduate Prize 1997 — Prizewinning Entry Menstrual Management: An Exploratory Study. FEMINISM & PSYCHOLOGY 2016. [DOI: 10.1177/095935359800800205] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Liu Q, Li R, Zhou R, Li J, Gu Q. Abnormal Resting-State Connectivity at Functional MRI in Women with Premenstrual Syndrome. PLoS One 2015; 10:e0136029. [PMID: 26325510 PMCID: PMC4556707 DOI: 10.1371/journal.pone.0136029] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 07/30/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Premenstrual syndrome (PMS) refers to a series of cycling and relapsing physical, emotion and behavior syndromes that occur in the luteal phase and resolve soon after the onset of menses. Although PMS is widely recognized, its neural mechanism is still unclear. DESIGN To address this question, we measured brain activity for women with PMS and women without PMS (control group) using resting-state functional magnetic resonance imaging (rs-fMRI). In addition, the participants should complete the emotion scales (Beck Anxiety Inventory, BAI; Beck Depression Inventory, BDI, before the scanning) as well as the stress perception scale (Visual analog scale for stress, VAS, before and after the scanning). RESULTS The results showed that compared with the control group, the PMS group had decreased connectivity in the middle frontal gyrus (MFG) and theparahippocampalgyrus (PHG), as well as increased connectivity in the left medial/superior temporal gyri (MTG/STG) and precentralgyrus within the default mode network (DMN); in addition, the PMS group had higher anxiety and depression scale scores, together with lower stress perception scores. Finally, there were significantly positive correlations between the stress perception scores and functional connectivity in the MFG and cuneus. The BDI scores in the PMS group were correlated negatively with the functional connectivity in the MFG and precuneus and correlated positively with the functional connectivity in the MTG. CONCLUSION These findings suggest that compared with normal women, women with PMS displayed abnormal stress sensitivity, which was reflected in the decreased and increased functional connectivity within the DMN, blunted stress perception and higher depression.
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Affiliation(s)
- Qing Liu
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, P. R. China
- Research Center of Emotion Regulation, Beijing Normal University, Beijing, P. R. China
| | - Rui Li
- Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P. R. China
| | - Renlai Zhou
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, P. R. China
- Department of Psychology, School of Social and Behavioral Science, Nanjing University, Nanjing, P. R. China
- Research Center of Emotion Regulation, Beijing Normal University, Beijing, P. R. China
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, P. R. China
- * E-mail:
| | - Juan Li
- Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P. R. China
| | - Quan Gu
- Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, Beijing, P. R. China
- Research Center of Emotion Regulation, Beijing Normal University, Beijing, P. R. China
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11
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Effects of menstrual cycle and neuroticism on females' emotion regulation. Int J Psychophysiol 2014; 94:351-7. [DOI: 10.1016/j.ijpsycho.2014.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 09/26/2014] [Accepted: 10/05/2014] [Indexed: 01/28/2023]
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Ussher JM, Perz J. PMS as a process of negotiation: Women’s experience and management of premenstrual distress. Psychol Health 2013; 28:909-27. [DOI: 10.1080/08870446.2013.765004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zhang W, Zhou R, Ye M. MENSTRUAL CYCLE MODULATION OF THE LATE POSITIVE POTENTIAL EVOKED BY EMOTIONAL FACES 1,2,3. Percept Mot Skills 2013. [DOI: 10.2466/22.27.pms.116.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Zhang W, Zhou R, Ye M. Menstrual Cycle Modulation of the Late Positive Potential Evoked by Emotional Faces. Percept Mot Skills 2013; 116:707-23. [DOI: 10.2466/22.27.pms.116.3.707-723] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The objective of the present study was to elucidate the time course and neural basis of facial expression recognition as modulated by the menstrual cycle in women. Event-related potentials (ERPs) associated with recognition of different emotional faces were assessed in 29 healthy women during the premenstrual, post-menstrual, and periovulation phases of the menstrual cycle. Accuracy in recognizing different facial expressions was not affected by the menstrual cycle phase. ERP data indicated that only the late positive potential (LPP) was affected by the menstrual cycle phase for all facial expressions: during the periovulation phase, the amplitude of the LPP (750 to 1,000 msec. post-stimulus) was larger than that during the premenstrual phase. A positive correlation between the amplitude of the LPP and facial expression recognition performance was observed only during the periovulation phase. The present study provides electrophysiological evidence that the LPP evoked by emotional faces is modulated by the menstrual cycle, which may be correlated with fluctuations of ovarian hormones.
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Affiliation(s)
- Wenjuan Zhang
- Beijing Key Lab of Applied Experimental Psychology, Beijing Normal University
| | - Renlai Zhou
- Beijing Key Lab of Applied Experimental Psychology and State Key Laboratory of Cognitive Neurosciences and Learning, Beijing Normal University
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Schmidt PJ, Rubinow DR. Reproductive hormonal treatments for mood disorders in women. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22033644 PMCID: PMC3181679 DOI: 10.31887/dcns.2002.4.2/pschmidt] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There has been a century-long view in medicine that reproductive function in both men and women is intimately involved with mood regulation. The 19th century witnessed a proliferation of medical reports documenting beneficial effects on mood and behavior after medical or surgical manipulations of women's reproductive functíon. More recently, the results of several studies suggest that gonadal steroids do regulate mood in some women. Thus, there is considerable interest in the potential role of reproductive therapies in the management of depressive illness, including both classical and reproductive endocrine-related mood disorders. Future studies need to determine the predictors of response to hormonal therapies compared with traditional antidepressant agents, and to characterize the long-term safety and benefits of these therapies.
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Affiliation(s)
- Peter J Schmidt
- Behavioral Endocrinology Branch, National Institute of Mental Health, Bethesda, Md, USA
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Steinberg EM, Cardoso GM, Martinez PE, Rubinow DR, Schmidt PJ. Rapid response to fluoxetine in women with premenstrual dysphoric disorder. Depress Anxiety 2012; 29:531-40. [PMID: 22565858 PMCID: PMC3442940 DOI: 10.1002/da.21959] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 02/01/2012] [Accepted: 03/30/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Selective serotonin reuptake inhibitors (SRIs) relieve irritability within days in women with premenstrual dysphoric disorder (PMDD); however, the effects on other affective symptoms in PMDD remain to be demonstrated. METHODS We performed hourly ratings in women with PMDD to test the specificity of the therapeutic effects of SRIs and to determine whether the kinetics of these effects differ from those of the symptom offset accompanying menses. Twelve women with PMDD received fluoxetine (20 mg daily) during the luteal phase of the menstrual cycle. Twelve other women with PMDD received no treatment. Outcome measures included a visual analogue scale completed hourly before and after either the start of SRIs or at menses-onset in the untreated women and the premenstrual tension syndrome (PMTS) scale completed daily. Data were analyzed by ANOVA-R. RESULTS Hourly VAS scores significantly improved after SRI in irritability as well as sadness, anxiety, and mood swings. Compared with the symptomatic pretreatment baseline, PMTS scores significantly improved on the second day after the start of SRI (p < .01). An identical time course of symptom improvement occurred after both SRI and menses-onset. CONCLUSION AND DISCUSSION These data document that the rapid response to SRI was not limited to irritability. The similar kinetics in the remission of PMDD after SRIs and after menses-onset suggest both a phenotype reflecting the relative capacity to rapidly change affective state, and a possible therapeutic mechanism by which SRIs recruit this endogenous capacity to change state, normally expressed around menses-onset in women with PMDD.
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Affiliation(s)
- Emma M. Steinberg
- Behavioral Endocrinology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health & Human Services, Bethesda, Maryland
| | - Graca M.P. Cardoso
- Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon Portugal
| | - Pedro E. Martinez
- Behavioral Endocrinology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health & Human Services, Bethesda, Maryland
| | - David R. Rubinow
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, North Carolina
| | - Peter J. Schmidt
- Behavioral Endocrinology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health & Human Services, Bethesda, Maryland
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Shuli X. Clinical study on treatment of premenstrual syndrome by acupuncture and moxibustion. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2011. [DOI: 10.1007/s11726-011-0540-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Potter J, Bouyer J, Trussell J, Moreau C. Premenstrual syndrome prevalence and fluctuation over time: results from a French population-based survey. J Womens Health (Larchmt) 2009; 18:31-9. [PMID: 19105683 DOI: 10.1089/jwh.2008.0932] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To explore the experience of reproductive-age women in the French population with premenstrual syndrome (PMS) by estimating perceived symptom prevalence, identifying risk factors, and quantifying the burden of symptoms. This study also assesses the stability of the PMS diagnosis over a 1-year period of follow-up. METHODS The prevalence of reported PMS was estimated from a population-based cohort of 2863 French women interviewed in 2003 and 2004. Multivariate logistic regressions were used to identify risk factors associated with PMS. PMS fluctuation was studied by comparing women's responses in 2003 and 2004. RESULTS Results show that 4.1% of women qualified for severe PMS (six symptoms) and 8.1% qualified for moderate PMS (one to five symptoms), resulting in 12.2% of women who reported PMS symptoms that impacted their daily lives. Risk factors for PMS fell into three categories: hormonal, psychosocial, and physiological, with life stressors and exogenous hormonal exposure exerting the most substantial impact. Results also indicate a high level of intraindividual variation in PMS status over time; among women who qualified for PMS during 1 or both years of the study, 72% demonstrated fluctuation in their PMS status. CONCLUSIONS More women report suffering from distressing premenstrual symptoms than are captured by strict premenstrual dysphoric disorder (PMDD) diagnostic criteria. The impact of PMS symptoms on women appears to fluctuate over time, however, producing greater variability in the syndrome than previously recognized. Clinicians should be mindful of high intraindividual variability in the syndrome when advising patients about long-term management.
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Affiliation(s)
- Julia Potter
- Institut National de la Santé et de la Recherche Médical, Department of Epidemiology, Demography, and Social Sciences, Le Kremlin-Bicetre, France
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Greco T, Graham CA, Bancroft J, Tanner A, Doll HA. The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: a comparison of two triphasic formulations containing norgestimate and either 35 or 25 μg of ethinyl estradiol. Contraception 2007; 76:8-17. [PMID: 17586130 DOI: 10.1016/j.contraception.2007.04.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2006] [Revised: 03/08/2007] [Accepted: 03/10/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE This study compared two oral contraceptives (OCs) with the same triphasic regimen of progestin (norgestimate 0.18, 0.215 and 0.25 mg) but differing doses of ethinyl estradiol (EE) - 25 and 35 microg EE - in their effects on androgens, mood and sexual interest in women starting on OCs. METHODS Total testosterone (T), free testosterone (FT), sex-hormone-binding globulin (SHBG) and dehydroepiandrosterone sulphate (DHEA-S), together with measures of mood [Beck Depression Inventory (BDI)], sexual interest [Dyadic and Solitary subscales of the Sexual Desire Inventory (SDI)] and self-reported side effects were assessed before starting on the OC and again after 3 months of use. RESULTS Sixty women, all university students, were randomized to receive either the 25 microg EE (N/EE25) or the 35 microg EE (N/EE35) pill; 12 women discontinued, leaving 48 who completed the 3-month study. Their mean age was 19.7 years (18-30) and they were predominantly white and single. Both OCs produced reductions in mean T [N/EE35: from 1.33 to 0.60 nmol/L, p<.001; N/EE25: from 1.12 to 1.02 nmol/L; nonsignificant (NS)] and FT (N/EE35: from 41.3 to 4.4 pmol/L, p<.001; N/EE25: from 25.4 to 7.9 pmol/L, p<.01), but the reduction in both T and FT was significantly greater with the higher EE dose (N/EE35) (p=.05 and p=.03, respectively). DHEA-S was also reduced with both formulations (N/EE35: from 7.26 to 5.22 micromol/L); N/EE25: from 7.50 to 5.39 micromol/L), although the reduction was only significant in the N/EE35 group (p<.02). Considerable variability in changes in mood was evident with both OCs, with some women showing predominantly negative effects (10 in N/EE35, 5 in N/EE25); others, positive effects (9 in N/EE35, 17 in N/EE25) and some, no change (four in each group). Women using N/EE25 were significantly more likely to show improvement in premenstrual mood than those in the N/EE35 group (p<.02), although there was no correlation between changes in BDI and FT or DHEA-S. Sexual interest scores did not change significantly from baseline to posttreatment with either OC (N/EE35: dyadic, from 40.5 to 39.6, NS; solitary, from 5.9 to 6.4, NS; N/EE25: dyadic, from 36.7 to 37.0, NS; solitary, from 5.0 to 4.2, NS). CONCLUSION The lower EE pill reduced FT less and was associated with greater improvement in premenstrual mood. A causal relation between these two effects is uncertain.
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Affiliation(s)
- Teri Greco
- Department of Medicine, Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis, IN 40202, USA
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Van-Leeson T, Totterdell P, Parkinson B. Moderating effects of mood monitoring on premenstrual dysphoria. Cogn Emot 2006. [DOI: 10.1080/02699930500387519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wieck A, Davies RA, Hirst AD, Brown N, Papadopoulos A, Marks MN, Checkley SA, Kumar RC, Campbell IC. Menstrual cycle effects on hypothalamic dopamine receptor function in women with a history of puerperal bipolar disorder. J Psychopharmacol 2003; 17:204-9. [PMID: 12870568 DOI: 10.1177/0269881103017002009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Neuroendocrine challenge tests of hypothalamic dopamine receptor function in the early postpartum period suggest that the sensitivity of these receptors is increased in women with a history of bipolar disorder after childbirth. We tested the hypothesis that, in women predisposed to bipolar disorder in the puerperium, hypothalamic dopamine receptor function is more sensitive to changes in circulating ovarian hormone concentrations than in women without such histories. Eight fully recovered and drug-free women who had had at least one episode of bipolar illness following childbirth were compared with nine normal controls. Growth hormone (GH) responses to apomorphine (APO 0.005 mg s.c.) were measured in the early follicular phase, when plasma concentrations of ovarian hormones are low, and in the mid-luteal phase, when they are relatively high. The recovered bipolar subjects and the controls did not differ from each other in their follicular and midluteal oestrogen and progesterone concentrations. In the midluteal phase, both groups had increased oestrogen and progesterone levels. The recovered bipolar subjects did not differ from controls in baseline concentrations of GH in either of the menstrual phases. The APO-GH responses of the two groups did not differ in the follicular phase, but in the midluteal phase, when female sex steroids are relatively increased, the recovered group had significantly enhanced APO-GH responses [MANOVA for repeated measures: (i) area under the curve, group by phase effect: p < 0.04; (ii) GH peak rise after APO, group by phase effect: p < 0.056] and the responses were not related to concurrent measures of mood. The results of this small study of women predisposed to bipolar disorder in the puerperium shows an increased dopaminergic receptor sensitivity in the luteal phase of the menstrual cycle. It suggests that their dopaminergic systems have increased sensitivity to changes in circulating female sex steroids. This may be aetiologically relevant to the pathogenesis of puerperal bipolar disorder.
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Affiliation(s)
- A Wieck
- Institute of Psychiatry, King's College London, De Crespigny Park, London, UK.
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Smith H, Thomas SP. Anger and locus of control in young women with and without premenstrual syndrome. Issues Ment Health Nurs 1996; 17:289-305. [PMID: 8920332 DOI: 10.3109/01612849609009402] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study was to examine differences in locus of control and anger in college women with and without premenstrual syndrome (PMS). One hundred thirty-seven female undergraduates completed a biographical questionnaire, the Rotter Internal-External Locus of Control (I-E) Scale, the Spielberger State Trait Anger Scale (STAS), the Framingham Anger Scale (FAS), and a women's health questionnaire. After 65 women who had had children or used hormonally based contraceptives or psychotropic medications were excluded, the remaining subjects were placed into a PMS (n = 48) or a non-PMS group (n = 24) according to whether they met DSM-IV criteria for Premenstrual Dysphoric Disorder (PMDD). After debriefing the sample, the women were asked if they believed they had PMS. Results of the study showed no significant differences between groups in locus of control or anger. Out of the 72 subjects in the final analysis, 64 (89%) believed they had PMS, and only 8 (or 11%) believed they did not. Self-diagnosis was not always correct; 16 (22%) of the women who believed they had PMS did not meet the DSM-IV criteria for the disorder. The DSM-IV criteria may need further refinement and validation.
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Dye L, Warner P, Bancroft J. Food craving during the menstrual cycle and its relationship to stress, happiness of relationship and depression; a preliminary enquiry. J Affect Disord 1995; 34:157-64. [PMID: 7560543 DOI: 10.1016/0165-0327(95)00013-d] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The associations between retrospective ratings of food craving and depression during the premenstrual, menstrual and postmenstrual phases of the preceding menstrual cycle and ratings of current levels of stress and happiness of relationship were examined in 5,546 women. In each phase examined, the severity of food craving was very strongly related to the reported severity of depression. Overall levels of food craving were inversely related to happiness of relationship and there was some interaction of this effect with on-going stress. However, once the effect of depression was accounted for there was no effect of either current stress or happiness of relationship on the cycle-related pattern of food craving and in general the magnitude of the effect of these psychosocial variables was very small compared with that of depression. Food cravings were also reported in the absence of depression, tending to show a cycle-related pattern, maximal premenstrually, declining during menstruation and further postmenstrually. Whilst this is consistent with a cycle-related biological explanation, it remains unclear whether the striking amplification of food craving ratings in association with co-existing depression, in all three phases examined, is also biologically based or dependent on psychological mechanisms. In view of the retrospective nature of the ratings of mood and craving and the limited assessment of stress and happiness of relationship, these findings should be regarded as preliminary. They are, however, of potential importance and the association between these two common phenomena deserves further study.
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Affiliation(s)
- L Dye
- Department of Psychology, Leeds University, UK
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Abstract
The dietary technique of acute tryptophan depletion was used to suppress brain serotonin synthesis in 16 women with documented premenstrual syndrome. Each subject was tested at distinct phases of each of two menstrual cycles. Baseline amino acid levels did not vary across the menstrual cycle, except for tyrosine which showed a significant premenstrual decrement. Compared to a sham procedure, actual tryptophan depletion caused a significant aggravation of premenstrual symptoms, particularly irritability. Symptom magnitude was correlated with diminution of tryptophan relative to other amino acids. This result supports other evidence implicating serotonin in premenstrual syndrome.
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Affiliation(s)
- D B Menkes
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
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