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Schmalenberger KM, Eisenlohr-Moul TA, Jarczok MN, Schneider E, Barone JC, Thayer JF, Ditzen B. Associations of luteal phase changes in vagally mediated heart rate variability with premenstrual emotional changes. BMC Womens Health 2024; 24:448. [PMID: 39118058 PMCID: PMC11308668 DOI: 10.1186/s12905-024-03273-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 07/18/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND A recent meta-analysis revealed that vagally mediated heart rate variability (vmHRV; a biomarker of emotion regulation capacity) significantly decreases in the luteal phase of the menstrual cycle. As two follow-up studies suggest, these vmHRV decreases are driven primarily by increased luteal progesterone (P4). However, analyses also revealed significant interindividual differences in vmHRV reactivity to the cycle, which is in line with longstanding evidence for interindividual differences in mood sensitivity to the cycle. The present study begins to investigate whether these interindividual differences in vmHRV cyclicity can explain who is at higher risk of showing premenstrual emotional changes. We expected a greater degree of midluteal vmHRV decrease to be predictive of a greater premenstrual increase in negative affect. METHODS We conducted an observational study with a naturally cycling community sample (N = 31, M = 26.03 years). Over a span of six weeks, participants completed (a) daily ratings of negative affect and (b) counterbalanced lab visits in their ovulatory, midluteal, and perimenstrual phases. Lab visits were scheduled based on positive ovulation tests and included assessments of baseline vmHRV and salivary ovarian steroid levels. RESULTS In line with previous research, multilevel models suggest that most of the sample shows ovulatory-to-midluteal vmHRV decreases which, however, were not associated with premenstrual emotional changes. Interestingly, it was only the subgroup with luteal increases in vmHRV whose negative affect markedly worsened premenstrually and improved postmenstrually. CONCLUSION The present study begins to investigate cyclical changes in vmHRV as a potential biomarker of mood sensitivity to the menstrual cycle. The results demonstrate a higher level of complexity in these associations than initially expected, given that only atypical midluteal increases in vmHRV are associated with greater premenstrual negative affect. Potential underlying mechanisms are discussed, among those the possibility that luteal vmHRV increases index compensatory efforts to regulate emotion in those with greater premenstrual negative affect. However, future studies with larger and clinical samples and more granular vmHRV assessments should build on these findings and further explore associations between vmHRV cyclicity and menstrually related mood changes.
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Affiliation(s)
- Katja M Schmalenberger
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL, 60612, USA.
- Institute of Medical Psychology, Center for Psychosocial Medicine (ZPM), Heidelberg University Hospital, Ruprecht Karl University of Heidelberg, Bergheimer Str. 20, Heidelberg, 69115, Germany.
| | - Tory A Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL, 60612, USA
| | - Marc N Jarczok
- Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, Ulm, 89081, Germany
| | - Ekaterina Schneider
- Institute of Medical Psychology, Center for Psychosocial Medicine (ZPM), Heidelberg University Hospital, Ruprecht Karl University of Heidelberg, Bergheimer Str. 20, Heidelberg, 69115, Germany
| | - Jordan C Barone
- Department of Psychiatry, University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL, 60612, USA
| | - Julian F Thayer
- Department of Psychological Science, School of Social Ecology, University of California Irvine, 5300 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine (ZPM), Heidelberg University Hospital, Ruprecht Karl University of Heidelberg, Bergheimer Str. 20, Heidelberg, 69115, Germany
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2
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Carmichael MA, Roberts AH, Donaldson A, Clarke AC. Implementing menstrual cycle tracking: A pilot concept mapping study investigating considerations of coaches, support staff, and female athletes. J Sci Med Sport 2024; 27:557-564. [PMID: 38777738 DOI: 10.1016/j.jsams.2024.04.003] [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: 10/22/2023] [Revised: 02/27/2024] [Accepted: 04/11/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES To identify what coaches, support staff, and athletes believe should be considered when implementing menstrual cycle tracking in sport. DESIGN Concept mapping (mixed-methods participatory approach). METHODS Participants brainstormed statements in response to the focus prompt "What should be considered when tracking menstrual cycles in sport?" Participants then sorted the statements into groups according to meaning and rated each statement on its importance and feasibility to address. RESULTS Twenty-six participants (12 athletes and 14 coaches/support staff) generated 53 ideas that the research team synthesised to 57 unique statements. Sixteen participants sorted the statements into an average of 8 (±4) groups. Six clusters were identified as the most appropriate representation of the sorting data following multidimensional scaling and hierarchical cluster analysis: 1) Ethics, 2) Tracking Tools and Methods, 3) Performance and Health, 4) Education, 5) Interpretation and Framing and 6) Communication. Participants rated each statement based on their importance (n = 12) and feasibility (n = 10), respectively. The most important (mean = 3.88 out of 5) and feasible (mean = 3.85 out of 5) cluster was Ethics, whilst the least important (mean = 3.17) and feasible (mean = 3.04) was Communication. CONCLUSIONS Ethical considerations pertaining to privacy, consent, and scope of practice should be prioritised when tracking menstrual cycles in sport. A low burden method of tracking, which allows for some individualisation based on athletes' preferences or needs, and menstrual health education should also be undertaken to improve the uptake and impact of menstrual cycle tracking.
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Affiliation(s)
- Mikaeli A Carmichael
- Sport, Performance, and Nutrition Research Group, Sport and Exercise Science, La Trobe University, Australia.
| | - Alexandra H Roberts
- Sport, Performance, and Nutrition Research Group, Sport and Exercise Science, La Trobe University, Australia; Talent and Coaching, Queensland Academy of Sport, Australia. https://twitter.com/AlexHRoberts
| | - Alex Donaldson
- Centre for Sport and Social Impact, La Trobe University, Australia. https://twitter.com/AlexDonaldson13
| | - Anthea C Clarke
- Sport, Performance, and Nutrition Research Group, Sport and Exercise Science, La Trobe University, Australia. https://twitter.com/DrAntheaClarke
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3
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Dal Brun D, Spagnolo G, Cuni B, Favaro A, Tenconi E, Meneguzzo P. Moving online: Implementation of virtual sessions of physical activity and movement training as a therapeutic approach to premenstrual symptoms. Heliyon 2023; 9:e15809. [PMID: 37180923 PMCID: PMC10173597 DOI: 10.1016/j.heliyon.2023.e15809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/13/2023] [Accepted: 04/23/2023] [Indexed: 05/16/2023] Open
Abstract
Background Aerobic exercise and movement training improve premenstrual syndrome (PMS) symptoms in women. However, the data is still preliminary, and online-based training has not been evaluated yet. Thus, this pilot study aims to assess the workability and usefulness of an online protocol based on aerobic exercise and movement training as an intervention for premenstrual symptoms. Methods A sample of 30 women from the general population was enrolled in this study, with an average age of 28.27 ± 9.35, and an average BMI of 23.47 ± 3.42 kg/m2. A total of 29 women completed an eight-week online protocol consisting of 30-min aerobic exercises twice a week, as well as a weekly 30-min movement training protocol. A psychological evaluation was conducted at the baseline and after completing the training via the patients' health questionnaire, the body weight image and self-esteem questionnaire, and the premenstrual symptoms screening tool, looking for changes in well-being and specific symptoms related to menses. Results Significant improvements in PMS (p = .015) and mood (p = .011) were recorded, with specific mood effects related to PMS symptomatology. The patients provided positive feedback on the protocol, and adherence was optimal. Conclusion The effectiveness of a combination of aerobic and isometric exercises was confirmed as a valuable tool in improving women's well-being and reducing premenstrual symptomatology, even if the protocol is delivered online, which tends to be more affordable for the participants than in-presence sessions. Future studies might assess the difference between online programs and face-to-face interventions.
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Affiliation(s)
- David Dal Brun
- Department of Linguistic and Literary Studies, University of Padova, Padova, Italy
| | - Giulia Spagnolo
- Department of Medicine – DIMED, University of Padova, Padova, Italy
| | - Beatrice Cuni
- Department of General Psychology, University of Padova, Padova, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
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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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5
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Nwimo IO, Elom NA, Ilo CI, Ezugwu UA, Ezugwu LE, Nkwoka IJ, Igweagu CP, Okeworo CG. Menstrual hygiene management practices and menstrual distress among adolescent secondary school girls: a questionnaire-based study in Nigeria. Afr Health Sci 2022; 22:397-409. [PMID: 36407370 PMCID: PMC9652681 DOI: 10.4314/ahs.v22i2.46] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
Background Menstruation is a common and normal experience during the reproductive age of adolescent females and if not well managed might expose the female to menstrual distress. Aim & Objectives To determine the menstrual hygiene management practices and menstrual distress among adolescent secondary school girls. Methods & Materials Six hundred participants randomly drawn participated in the study. A structured questionnaire which had two inventories was used to collect data. The first inventory was a self-developed Menstrual Hygiene Management Practices Questionnaire (MHMPQ) (r = 0.71) and the second one was a modified 11-item Menstrual Distress Scale (MDS) (r = 0.74). Data were analyzed using descriptive and inferential statistics. Results Results showed that menstrual hygiene management practices of the girls were poor and they were very highly distressed. Statistically significant differences were observed in menstrual hygiene management practices among the girls with regard to age, location of residence and occupation of mother and on menstrual distress in relation to occupation of father (p < 0.05). Significant positive relationship between menstrual hygiene management practices and menstrual distress was observed. Conclusion The findings accentuate the need for a caring atmosphere for menstrual sanitation both at home and in school.
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Affiliation(s)
- Ignatius O Nwimo
- Department of Human Kinetics and Health Education, Ebonyi State University, Abakaliki, Nigeria
| | - Nwamaka A Elom
- Department of Human Kinetics and Health Education, Ebonyi State University, Abakaliki, Nigeria
| | - Cajetan I Ilo
- Department of Human Kinetics and Health Education, Ebonyi State University, Abakaliki, Nigeria
| | - Uchechukwu A Ezugwu
- Department of Medical Rehabilitation, University of Nigeria, Nsukka, Nigeria
| | | | - Ifeanyi J Nkwoka
- Department of Community Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Chukwuma P Igweagu
- Department of Community Medicine, Enugu State University of Science and Technology, Enugu, Nigeria
| | - Chukwuma G Okeworo
- Department of Sociology and Anthropology, Nnamdi Azikiwe University, Awka, Nigeria
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Alimoradi Z, Rajabalipour S, Rahmani K, Pakpour AH. The effect of a social network-based cognitive behavioral therapy intervention on the severity of premenstrual syndrome symptoms: a protocol of a randomized clinical trial study. Trials 2022; 23:346. [PMID: 35461297 PMCID: PMC9034079 DOI: 10.1186/s13063-022-06290-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 04/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Premenstrual syndrome (PMS) is one of the most widespread menstrual disorders in women of reproductive age. This recurrent syndrome is a combination of physically, mentally, or behaviorally disturbing changes occurring during the secretory phase of the menstrual cycle. The aim of this study is to determine the effect of a cognitive-behavioral therapy-based educational intervention using social networks on PMS in female health center employees in Rudbar, Iran. Methods/design A randomized superiority controlled trial will be conducted involving 140 female employees of health centers affiliated with the Guilan University of Medical Sciences, Rudbar. The study involves a block size of 4 and 6 in a randomly varied order, 140 women who meet all the inclusion criteria will be randomly and equally divided into 2 groups: the intervention and the control groups. Those in the former group will receive a cognitive-behavioral therapy-based treatment for eight consecutive weeks on the social network platform WhatsApp; however, those in the control group will not be offered any treatment except usual care practices (unprotocolized usual care). The study’s primary outcome is the severity of PMS symptoms, and the secondary outcomes include general self-efficacy, work-related quality of life, the impact of PMS on daily life, coping with the symptoms, and experiencing anxiety and depression at the beginning of the study to identify people with PMS. A daily record of the symptoms will be completed for two consecutive months by all female employees aged 20–45 years who wish to participate in the study. According to the initial screening, those with moderate to severe PMS will be included. We will use the MLwin software for the analyses. All questionnaires will be completed by both groups immediately and 8 weeks after the termination of the treatment. The data will be analyzed using linear mixed-effects modeling with random intercepts and slopes. Discussion It is anticipated that the findings of the present study may demonstrate the effectiveness of the cognitive behavioral therapy intervention on the severity of PMS symptoms that could guide healthcare providers in opting for suitable treatment alternatives for the syndrome. Ethics and dissemination The research proposal is approved by the Human Ethics Committee of Qazvin University of Medical Sciences (IR.QUMS.REC.1399.252). The results of this intervention trial will be submitted for publication in a peer-reviewed research journal. Trial registration Iranian Registry of Clinical Trials IRCT20180218038789N4. Registered prospectively on October 28, 2020
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center,Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, 34197-59811, Iran
| | | | - Khaled Rahmani
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amir H Pakpour
- Social Determinants of Health Research Center,Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, 34197-59811, Iran. .,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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7
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Frey BN, Allega OR, Eltayebani M, Syan SK, Mendes-Ribeiro J, Minuzzi L. A DSM-5-based tool to monitor concurrent mood and premenstrual symptoms: the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS). BMC Womens Health 2022; 22:96. [PMID: 35354450 PMCID: PMC8969316 DOI: 10.1186/s12905-022-01678-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background Despite high co-morbidity between premenstrual dysphoric disorder and mood disorders, there is a gap of research-based tools to monitor concurrent premenstrual and mood symptoms. In this study, we developed a new DSM-5-based questionnaire to prospectively monitor concurrent premenstrual and mood symptoms.
Methods Fifty-two females with bipolar or major depressive disorder, ages 16–45, were enrolled in the study. Participants completed two months of prospective symptom charting including the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS) and the Daily Record of Severity of Problems (DRSP). At the end of the prospective charting, participants also completed the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). The MAC-PMSS was correlated with the DRSP, MADRS, HDRS and YMRS. Results All individual items of the MAC-PMSS correlated strongly with the individual DRSP scores (all p < 0.001). The mood section of the MAC-PMSS also significantly correlated with MADRS (r = 0.572; p < 0.01), HDRS (r = 0.555; p < 0.01) and YMRS scores (r = 0.456; p < 0.01). Conclusions The MAC-PMSS is a reliable to tool to measure concurrent mood and premenstrual symptoms in women with mood disorders.
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Affiliation(s)
- Benicio N Frey
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada. .,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada. .,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Olivia R Allega
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada
| | - Maha Eltayebani
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Department of Neuropsychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Sabrina K Syan
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada
| | - Jeronimo Mendes-Ribeiro
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada
| | - Luciano Minuzzi
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, 100 West 5th Street, Suite C124, Hamilton, ON, L8N 3K7, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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8
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Olliges E, Bobinger A, Weber A, Hoffmann V, Schmitz T, Popovici RM, Meissner K. The Physical, Psychological, and Social Day-to-Day Experience of Women Living With Endometriosis Compared to Healthy Age-Matched Controls-A Mixed-Methods Study. Front Glob Womens Health 2022; 2:767114. [PMID: 34977863 PMCID: PMC8714740 DOI: 10.3389/fgwh.2021.767114] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Endometriosis is characterized by lesions of endometrial tissue outside the uterus. Chronic pain is considered as main symptom, but challenges can relate to various physical, mental, and social aspects of the women's lives. The aim of our study was to gain a holistic understanding of the everyday reality of women with endometriosis compared to healthy controls. Methods: The total sample comprised 12 hormone-free endometriosis patients (EP) and 11 age-matched healthy women (HC). A mixed-methods design was used comprising semi-structured interviews, standardized questionnaires and a comprehensive diary to assess pain ratings and various mental and physical symptoms over the course of a menstrual cycle. Interviews were recorded, transcribed, and evaluated according to phenomenological analysis using the MAXQDA software. Results: Interviews showed that living with endometriosis was associated with an impairment in everyday life. Physical strains, especially pain, high levels of psychological distress, and social limitations have been reported. Living with endometriosis affected the patients' personality and they “no longer felt like themselves.” Physical and psychological symptoms were reported to interfere with social interaction and participation. Evaluation of the standardized questionnaires revealed significant impairments in EP compared to HC in regard to anxiety and depression scores (both p < 0.001; Hospital Anxiety and Depression Scale), mental and physical quality of life (both p < 0.001; Short-Form Health Survey-12), stress ratings (p < 0.001; Patient Health Questionnaire-15) and functional well-being (p < 0.001; Functional Well-being-7). The highest levels of mean pelvic pain and dyschezia were observed in EP during menstruation, but mean pain ratings and dyschezia were increased in EPs compared to HP during the whole cycle. EP reported mental symptoms (e.g., depressed mood or anxiety) mainly during menstruation, while HC did not show any mental symptoms during the cycle. In addition, physical symptoms were elevated during the entire cycle in EPs (all p < 0.01). Discussion: The mixed-methods approach enabled to interpret the interviews, the standardized questionnaires, and the symptom diary in a broader context of everyday life. The symptoms do not appear to act independently, but rather influence each other. This leads to a complex interplay of physical, mental, and social impairments, with pain often being the starting point.
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Affiliation(s)
- Elisabeth Olliges
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany.,Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Barmelweid, Switzerland
| | - Alina Bobinger
- Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany
| | - Annemarie Weber
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany
| | - Verena Hoffmann
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany
| | - Timo Schmitz
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany.,Chair of Epidemiology, University of Augsburg, Augsburg, Germany
| | - Roxana M Popovici
- Kïz, Munich, Germany.,Department of Gynecologic Endocrinology and Fertility Disorders, Heidelberg University Women's Hospital, Heidelberg, Germany
| | - Karin Meissner
- Faculty of Medicine, Institute of Medical Psychology, LMU Munich, Munich, Germany.,Division of Health Promotion, Coburg University of Applied Sciences, Coburg, Germany
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Abstract
The aim of this study was to determine the prevalence of premenstrual syndrome among reproductive age women living in Turkey with a systematic review and meta-analysis study. In this study were scanned keywords ['premenstrual syndrome' and prevalence and Turkish] in the databases including Turkish Medline, PubMed, Google Scholar, Scopus and ISI Web of Knowledge. This study included full-text research articles from conducted in Turkey, published in Turkish or English between 2014 and 2018 and indicating prevalence. This study included a total of 18 studies conducted in Turkey reporting the prevalence of premenstrual syndrome. A total of 6890 women participated in these studies. The overall premenstrual syndrome prevalence in the studies examined in this systematic review was 52.2%. Subgroup prevalence was found to be 59% in high school students, 50.3% in university students and 66% of women in general population. In the meta-regression analysis showed that there was no significant relationship between the mean age of the participants with the prevalence of premenstrual syndrome. The results of the study showed that premenstrual syndrome was prevalent among Turkish reproductive age women. Health professionals should organize training for women to gain the ability to manage PMS symptoms. Further interventional studies are needed to cope with PMS.
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Affiliation(s)
- Nülüfer Erbil
- Department of Gynecologic and Obstetrics Nursing, Faculty of Health Sciences, Ordu University, Ordu, Turkey
| | - Hüsne Yücesoy
- Institute of Health Sciences, Department of Gynecologic and Obstetrics Nursing, Ordu University, Ordu, Turkey
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10
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Gao M, Sun H, Sun W, Gao D, Qiao M. Traditional Chinese medicine on treating premenstrual syndrome and premenstrual dysphoric disorder: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22694. [PMID: 33080718 PMCID: PMC7571909 DOI: 10.1097/md.0000000000022694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common disorders that manifest themselves in the late luteal phase, and significantly interfere with an individual's daily activities. Clinical evidence suggests that traditional Chinese medicine (TCM) may ease PMS/PMDD symptoms. Here, we review a protocol for exploring the effectiveness and safety of TCM in PMS/PMDD management. METHODS We will conduct a literature search for randomized controlled trials (RCT) for TCM use in PMS/PMDD on PubMed, web of science, EMBASE, the Cochrane central register of controlled trials (Cochrane Library), Chinese national knowledge infrastructure, Chinese VIP Information, Wanfang, as well as Chinese biomedical literature database. The search included all relevant reports for up to June 1, 2020. The search results were independently analyzed by 2 reviewers who extracted the data. RCT quality will be assessed using the risk-of-bias tool. The evidence will be inspected using the grading of recommendations assessment development and evaluation (GRADE). We will utilize Stata and Revman for systematic review and meta-analysis and analysis of direct and indirect evidence. RESULTS Based on current evidence, this study will elucidate the rationale for the utilization of TCM in PMS/PMDD treatment. CONCLUSION Conclusions from this study will inform about the effectiveness and safety of TCM in PMS/PMDD management. TRIAL REGISTRATION NUMBER CRD42020192822. ETHICS AND DISSEMINATION Since all data utilized in this systematic review and meta-analysis are published, ethical approval is not needed. Additionally, in the trial of the review process, all data will be evaluated anonymously.
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Affiliation(s)
- Mingzhou Gao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
- Research and Innovation team of Emotional Diseases and Syndromes in Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Hui Sun
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, Hubei Province
| | - Wenjun Sun
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
- Research and Innovation team of Emotional Diseases and Syndromes in Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Dongmei Gao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
- Research and Innovation team of Emotional Diseases and Syndromes in Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
| | - Mingqi Qiao
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
- Research and Innovation team of Emotional Diseases and Syndromes in Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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11
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Eisenlohr-Moul TA, Kaiser G, Weise C, Schmalenberger KM, Kiesner J, Ditzen B, Kleinstäuber M. Are there temporal subtypes of premenstrual dysphoric disorder?: using group-based trajectory modeling to identify individual differences in symptom change. Psychol Med 2020; 50:964-972. [PMID: 31010447 PMCID: PMC8168625 DOI: 10.1017/s0033291719000849] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Premenstrual dysphoric disorder (PMDD) is a new Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnosis characterized by the cyclical emergence of emotional and physical symptoms in the luteal phase of the menstrual cycle, with symptom remission in the follicular phase. Converging evidence highlights the possibility of distinct subtypes of PMDD with unique pathophysiologies, but temporal subgroups have yet to be explored in a systematic way. METHODS In the current work, we use group-based trajectory modeling to identify unique trajectory subgroups of core emotional and total PMDD symptoms across the perimenstrual frame (days -14 to +9, where day 0 is menstrual onset) in a sample of 74 individuals prospectively diagnosed with DSM-5 PMDD. RESULTS For the total daily symptom score, the best-fitting model was comprised of three groups: a group demonstrating moderate symptoms only in the premenstrual week (65%), a group demonstrating severe symptoms across the full 2 weeks of the luteal phase (17.5%), and a group demonstrating severe symptoms in the premenstrual week that were slow to resolve in the follicular phase (17.5%). CONCLUSIONS These trajectory groups are discussed in the context of the latest work on the pathophysiology of PMDD. Experimental work is needed to test for the presence of possible pathophysiologic differences in trajectory groups, and whether unique treatment approaches are needed.
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12
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Frey Nascimento A, Gaab J, Kirsch I, Kossowsky J, Meyer A, Locher C. Open-label placebo treatment of women with premenstrual syndrome: study protocol of a randomised controlled trial. BMJ Open 2020; 10:e032868. [PMID: 32071176 PMCID: PMC7045079 DOI: 10.1136/bmjopen-2019-032868] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Recent evidence suggests that for certain clinical conditions, placebos can improve clinical outcomes even without deception. These so-called open-label placebos (OLPs) bear the advantage of a significant lower risk of adverse events and comply with ethical principles. Although premenstrual syndrome (PMS) seems to be considerably susceptible to placebo effects, no study has examined open-OLP responses on PMS. METHODS AND ANALYSIS To test the efficacy of OLPs in women suffering from PMS, a clinical randomised controlled trial including two OLP study groups (with and without treatment rationale) was designed to investigate on the effect on PMS. PMS symptoms are monitored on a daily basis via a symptom diary, adverse events are monitored intermittently. The study started in spring 2018 and patients will be included until a maximum of 150 participants are randomised. Besides the primary outcome PMS symptom intensity and interference, an array of further variables is assessed. Multilevel modelling will be used for data analyses. ETHICS AND DISSEMINATION Ethics approval was obtained from the Ethics Committee Northwest and Central Switzerland. Results of the main analysis and of secondary analyses will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBERS: (1) ClinicalTrials.gov (NCT03547661); (2) Swiss national registration (SNCTP000002809).
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Affiliation(s)
- Antje Frey Nascimento
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland
| | - Irving Kirsch
- Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Joe Kossowsky
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland
- Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrea Meyer
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Cosima Locher
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland
- School of Psychology, University of Plymouth, Plymouth, UK
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13
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Aperribai L, Alonso-Arbiol I. The role of mental health variables and coping strategies in premenstrual syndrome. Health Care Women Int 2019; 41:368-379. [PMID: 31622184 DOI: 10.1080/07399332.2019.1663193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study we aimed to examine the relationship between PMS and some mental health variables (anxiety, depression, neuroticism) and coping strategies. We analyzed their predictive value by assessing 55 women's symptoms. We found that all the studied health variables and coping strategies were significantly correlated with reported PMS's Negative Symptomatology scores in the premenstrual phase. Interdisciplinary training programs on instrumental coping strategies might be carried out. In future studies researchers might examine how severe Depression would impact on PMS, and which specific intervention strategies would diminish PMS's distressing effects on women's quality of life worldwide.
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Affiliation(s)
- Leire Aperribai
- Department of Educational Psychology and Pedagogy, Begoñako Andra Mari Teacher Training University College, BAM, Bilbao, Spain
| | - Itziar Alonso-Arbiol
- Department of Psychology, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
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14
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Schoep ME, Adang EMM, Maas JWM, De Bie B, Aarts JWM, Nieboer TE. Productivity loss due to menstruation-related symptoms: a nationwide cross-sectional survey among 32 748 women. BMJ Open 2019; 9:e026186. [PMID: 31248919 PMCID: PMC6597634 DOI: 10.1136/bmjopen-2018-026186] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To evaluate age-dependent productivity loss caused by menstruation-related symptoms, measured in absenteeism (time away from work or school) and presenteeism (productivity loss while present at work or school). METHODS Design/setting: internet-based, cross-sectional survey conducted in the Netherlands from July to October 2017. PARTICIPANTS 32 748 women aged 15-45 years, recruited through social media. OUTCOME MEASURES self-reported lost productivity in days, divided into absenteeism and presenteeism; impact of menstrual symptoms; reasons women give when calling in sick; and women's preferences regarding the implications of menstruation-related symptoms for schools and workplaces. RESULTS A total of 13.8% (n=4514) of all women reported absenteeism during their menstrual periods with 3.4% (n=1108) reporting absenteeism every or almost every menstrual cycle. The mean absenteeism related to a woman's period was 1.3 days per year. A total of 80.7% (n=26 438) of the respondents reported presenteeism and decreased productivity a mean of 23.2 days per year. An average productivity loss of 33% resulted in a mean of 8.9 days of total lost productivity per year due to presenteeism. Women under 21 years were more likely to report absenteeism due to menstruation-related symptoms (OR 3.3, 95% CI 3.1 to 3.6). When women called in sick due to their periods, only 20.1% (n=908) told their employer or school that their absence was due to menstrual complaints. Notably, 67.7% (n=22 154) of the participants wished they had greater flexibility in their tasks and working hours at work or school during their periods. CONCLUSIONS Menstruation-related symptoms cause a great deal of lost productivity, and presenteeism is a bigger contributor to this than absenteeism. There is an urgent need for more focus on the impact of these symptoms, especially in women aged under 21 years, for discussions of treatment options with women of all ages and, ideally, more flexibility for women who work or go to school.
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Affiliation(s)
- Mark E Schoep
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
- Department of Obstetrics and Gynaecology, Hospital Rijnstate, Arnhem, The Netherlands
| | - Eddy M M Adang
- Department of Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Jacques W M Maas
- Obstetrics & Gynaecology, Maxima Medical Centre locatie Veldhoven, Veldhoven, The Netherlands
| | - Bianca De Bie
- Dutch Patient Endometriosis Foundation, Numansdorp, The Netherlands
| | - Johanna W M Aarts
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
| | - Theodoor E Nieboer
- Department of Obstetrics and Gynaecology, Radboudumc, Nijmegen, The Netherlands
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15
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Weise C, Kaiser G, Janda C, Kues JN, Andersson G, Strahler J, Kleinstäuber M. Internet-Based Cognitive-Behavioural Intervention for Women with Premenstrual Dysphoric Disorder: A Randomized Controlled Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2019; 88:16-29. [PMID: 30783069 DOI: 10.1159/000496237] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/16/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Given the high prevalence of clinically relevant premenstrual symptoms and the associated impairment, there is a need for effective treatments. Initial evidence suggests cognitive-behavioural therapy (CBT) as an effective treatment for premenstrual dysphoric disorder (PMDD). The aim of the current randomized clinical trial was to evaluate an Internet-based CBT (iCBT) to reduce the burden of PMDD. METHODS In all, 174 women with PMDD were recruited via newspaper articles, flyers, and social media. They were randomized to a treatment group (TG; n = 86) or waitlist control group (CG; n = 88). Women of the TG received an 8-week therapist-guided iCBT. Data were assessed before and after treatment/waiting, and 6 months after intervention with prospective symptom diaries and questionnaires in the premenstrual phase. Treatment effects and moderators were analysed using hierarchical linear modelling. RESULTS Significant time × group interaction effects on functional impairment and psychological impairment, impact on everyday life, symptom intensity, and symptom disability in favour of the TG indicated the efficacy of the treatment. Follow-up assessments demonstrated treatment effects to be stable until 6 months after treatment. Additionally, significant interactions with moderator variables were found. In the TG, higher levels of active coping and lower levels of support-seeking coping were associated with stronger improvement in interference in everyday life and symptom intensity. In addition, lower levels of perceived stress were associated with stronger improvement in functional impairment. CONCLUSION The iCBT was highly effective in reducing the burden of PMDD. It appears to be particularly important to address coping styles and stress management in the treatment.
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Affiliation(s)
- Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany,
| | - Gudrun Kaiser
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Carolyn Janda
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Johanna N Kues
- Department for Anaesthesiology and Intensive Care, Charité, Campus Benjamin Franklin, Berlin, Germany
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jana Strahler
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
| | - Maria Kleinstäuber
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany.,Department of Psychological Medicine, Dunedin Medical School, University of Otago, Dunedin, New Zealand
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16
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Janda C, Asbrock F, Herget M, Kues JN, Weise C. Changing the perception of premenstrual dysphoric disorder - An online-experiment using the Stereotype Content Model. Women Health 2019; 59:967-984. [DOI: 10.1080/03630242.2019.1584599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C. Janda
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - F. Asbrock
- Department of Psychology, Technische Universität Chemnitz, Chemnitz, Germany
| | - M. Herget
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - J. N. Kues
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - C. Weise
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany
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17
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Kaiser G, Janda C, Kleinstäuber M, Weise C. Clusters of premenstrual symptoms in women with PMDD: Appearance, stability and association with impairment. J Psychosom Res 2018; 115:38-43. [PMID: 30470315 DOI: 10.1016/j.jpsychores.2018.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/17/2018] [Accepted: 10/12/2018] [Indexed: 11/17/2022]
Abstract
Although premenstrual dysphoric disorder (PMDD) is assumed to be a homogenous diagnostic entity, it is hallmarked by highly diverse clinical symptoms. In this study, we investigate symptom clusters in women prospectively diagnosed with severe premenstrual syndrome (PMS) or PMDD using factor analysis; analyze the stability of the structures of different symptom patterns and their association with impairment at work, in recreation, and in relationships. A total of 174 prospective symptom diaries were analyzed with principal axis factoring revealing six clusters named affective dysphoria, somatic dysphoria, irritability, breast/body sensitivity, pain, and eating behavior. Cronbach's alpha was good for all clusters (0.83 to 0.91) with the exception of the cluster pain (0.69). Clusters of symptoms appeared to be stable between two consecutive menstrual cycles (except of pain and eating behavior) and between two cycles with a waiting period of eight weeks in between. Multiple regression analyses showed different associations of the clusters with impairment. Somatic dysphoria was the cluster most strongly associated with impairment. The results indicate that in severe PMS/PMDD, different symptom patterns should be considered. As the risk of impairment differs between symptom clusters, individual treatment options should be considered and further investigated in research and treatment.
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Affiliation(s)
- Gudrun Kaiser
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
| | - Carolyn Janda
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
| | - Maria Kleinstäuber
- Faculty of Medical and Health Sciences, School of Medicine, University of Auckland, New Zealand
| | - Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany
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18
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Kaiser G, Kues JN, Kleinstäuber M, Andersson G, Weise C. Methods for coping with premenstrual change: Development and validation of the German Premenstrual Change Coping Inventory. Women Health 2017; 58:1062-1079. [PMID: 29111950 DOI: 10.1080/03630242.2017.1377802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
During the premenstrual phase, psychological and physiological changes can occur, which are associated with different levels of disability. When they appear with Premenstrual Dysphoric Disorder (PMDD), different coping strategies may be used by women to deal with premenstrual changes. Currently no German measure exists for assessing premenstrual symptom-related coping strategies. Therefore, we developed the Premenstrual Change Coping Inventory (PMS-Cope). First, the 33-item questionnaire was tested with an exploratory factor analytic approach (EFA) in a sample of 150 women prospectively diagnosed with PMDD or severe Premenstrual Syndrome from August 2013 until March 2016. The EFA resulted in a 12-item scale with a two-factor structure: "seeking positive affect-inducing activities" and "seeking support"; Cronbach`s alpha of 0.73 and 0.71, respectively, demonstrated good reliability for both factors. Confirmatory factor analysis based on a second sample of 89 women conducted from May 2016 until June 2016 confirmed the two-factor structure. Additionally, a potential third factor "healthcare use behavior" was tested with an EFA. For the three-factor solution, satisfactory Cronbach's alpha values (0.70-0.72) were detected. The PMS-Cope was shown to be a valid, reliable, and economic measure. In future research, cross validations and confirmatory factor analyses with the three-factor solution should be conducted.
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Affiliation(s)
- Gudrun Kaiser
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-University of Marburg , Marburg , Germany
| | - Johanna N Kues
- 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
| | - Gerhard Andersson
- b Department of Behavioral Sciences and Learning , Linnaeus Centre HEAD, Linköping University , Linköping , Sweden.,c Psychiatry Section, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Cornelia Weise
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-University of Marburg , Marburg , Germany
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