Self-reported executive function, and not performance-based measures, strongly associates with symptoms of premenstrual syndrome/premenstrual dysphoric disorder / Autorreporte de funciones ejecutivas, y no medidas de desempeño, fuertemente se asocia con síntomas de síndrome premenstrual/trastorno disfórico premenstrual

Abstract Introduction Premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD) may be neuropsychologically understood as impairments of executive functions (EF), since these are related to the regulation of complex behavior and cognition. Objective To test the utility of self-report of EF versus performance-based measures, for the understanding of PMS/PMDD, and to analyze interactive effects between symptoms of these pathologies and EF on daily-life functionality. Method Mexican women were recruited through non-probabilistic procedures. The Premenstrual Symptoms Screening Tool (PSST) was used to determine severity of symptoms and functional impairment in daily-life activities, and the Behavioral Rating Inventory of Executive Functions-Adults (BRIEF-A) (short Spanish-translated version) adapted to collect information on EF during luteal versus follicular phases. Performance was evaluated with Stroop, Trail Making Test and Letter-Number Sequencing. Results A total of 157 were analyzed. Three groups were formed: No diagnosis ( n = 78); PMS ( n = 67) and PMDD ( n = 12). Between-group differences were observed for both BRIEF-A-Luteal and BRIEF-A-Follicular. Bivariate correlations between these measures and the PSST were found, with double the magnitude relative to BRIEF-A-Luteal. Only two indicators of performance-based measures were weakly associated to the PSST. The regression model showed high multicollinearity between self-reported EF and PMS/PMDD symptoms, and no interaction was found. Discussion and conclusion Self-report probed a better association than based-performance tests for the assessment of EF in PMS/PMDD. EF deficits and PMS/PMDD symptoms, particularly during luteal phase, may be as closely link as to allow for the consideration of these diagnoses as partial forms of dysexecutive syndrome.

Resumen Introducción El síndrome premenstrual/trastorno disfórico premenstrual (SPM/TDPM) pueden entenderse neuropsicológicamente como alteraciones de las funciones ejecutivas (FE), ya que éstas permiten la regulación del comportamiento complejo y la cognición. Objetivo Evaluar la utilidad del autorreporte de las FE versus pruebas de desempeño para comprender el SPM/TDPM, y analizar los efectos interactivos entre los síntomas de estas patologías y las FE sobre el funcionamiento diario. Método Mujeres mexicanas fueron reclutadas por medio de procedimientos no probabilísticos. El Instrumento de Detección de Síntomas Premenstruales (PSST) se utilizó para determinar la gravedad de los síntomas y el deterioro funcional en las actividades de la vida diaria, y el Inventario de Evaluación Conductual de la Función Ejecutiva-Adultos (BRIEF-A) (versión breve traducida al español) para recopilar información sobre EF durante las fases lútea versus folicular. Se emplearon también las pruebas de desempeño: Stroop, Trail Making Test y Secuencia de Letras y Números. Resultados Se analizó un total de 157 participantes. Se formaron tres grupos: sin diagnóstico ( n = 78); SPM ( n = 67) y TDPM ( n = 12). Se observaron diferencias entre los grupos para BRIEF-A-Lútea y BRIEF-A-Folicular. Se encontraron correlaciones bivariadas entre estas medidas y el PSST, con el doble de magnitud en relación con BRIEF-A-Lútea. Solo dos indicadores de medidas basadas en el desempeño mostraron una asociación débil con el PSST. El modelo de regresión mostró alta multicolinealidad entre el autorreporte de FE y SPM/TDPM, y no se encontró la interacción esperada. Discusión y conclusión El autorreporte mostró una mejor asociación que las pruebas de rendimiento para la evaluación de FE en SPM/TDPM. Los déficits de EF y los síntomas de SPM/TDPM, particularmente durante la fase lútea, pueden estar tan estrechamente vinculados como para permitir la consideración de estos diagnósticos como formas parciales de síndrome disejecutivo.

The mechanism of Shuyu capsules in treating premenstrual dysphoric disorder caused by liver qi depression based on microdialysis technology from the aspect of Glu-GABA metabolic pathway / 国际中医中药杂志

Objective:To explore the mechanism of premenstrual dysphoric disorder (PMDD) caused by liver-qi depression from the aspect of Glu-GABA metabolic pathways.Methods:Thirty-six rats with similar open field scores and regular estrus cycles were divided into blank group, model group, fluoxetine group, Shuyu capsule group, saikosaponin group and inhibitor group according to the random number table method, with 6 rats in each group. Stereotactic hippocampus surgery was performed during the first estrous cycle reception period after the estrus cycle was determined. In the non-receiving period of the third and fourth estrus cycles, the restraint model was constructed, and from the first day of the modeling, rats of the fluoxetine group were given fluoxetine capsules 2.67 mg/kg, while rats of the Shuyu capsule group and saikosaponin group were given Shuyu capsules 0.408 g/kg and saikosaponin 0.72 mg/kg once a day for 5 consecutive days. Rats in the inhibitor group were injected with 20 μl L-malic acid with 5 mmol/L concentration, which is an inhibitor of glutamate decarboxylase (GAD), in the hippocampus on the last day of modeling. After the administration, weighed the rats and carried out open field experiments. During the second and fivth estrus cycles of rats, the extracellular fluid of the hippocampus was collected by microdialysis technology, and the content of Glu and GABA in the dialysate was detected by HPLC-FLD. Results:After 5 days of administration, compared with the model group, the body weight of rats in the Shuyu capsule group, the inhibitor group and the fluoxetine group increased ( P<0.05), and the total score of the open field experiment decreased ( P<0.05); compared with the model group, during the receiving period of the five estrus cycle, the Glu level of the Shuyu capsule group and the inhibitor group decreased ( P<0.05); In the non-receiving period of the fifth estrus cycle, the Shuyu capsule group, Glu level of the fluoxetine group and the saikosaponin group increased, GABA level of Shuyu capsule group, inhibitor group and fluoxetine group decreased ( P<0.05), Glu/GABA level of Shuyu capsule group, fluoxetine group and inhibitor group (1.49 ± 0.13, 1.32 ± 0.33, 3.92 ± 0.79 vs. 0.35 ± 0.48) was higher than that of the model group ( P<0.05). Conclusion:The therapeutic mechanism of Shuyu capsule in the treatment of PMDD caused by liver Qi depression rats may be ascribed to inhibiting GAD from Glu-GABA metabolic pathway.

Fatores associados à síndrome pré-menstrual e ao transtorno disfórico pré-menstrual em estudantes da área de saúde / Factors associated with premenstrual syndrome and dysphoric disorder in health students

O estudo avaliou a frequência da síndrome pré-menstrual (SPM) e do transtorno disfórico pré-menstrual (TDPM) e fatores associados entre estudantes de cursos da área de saúde em uma universidade no Recife, Brasil. Realizou-se um corte transversal envolvendo 649 estudantes entre 18 e 47 anos, no período de setembro/2016 a março/2017. As estudantes que aceitaram participar do estudo e assinaram o termo de consentimento livre e esclarecido responderam a um questionário autoaplicável com dados sociodemográficos, hábitos de vida e antecedentes ginecológicos, bem como questões relacionadas aos critérios diagnósticos de SPM/TDPM. A maioria das estudantes tinha entre 18 e 24 anos (83,2%), era solteira (92,1%), morava com os pais (77,0%) e não trabalhava (84,4%). A frequência de SPM simples foi de 23,3% e da TDPM, de 26,7%. Os sinais e sintomas físicos foram os mais frequentes (84,1%) entre as estudantes com SPM. As 173 estudantes com TDPM relataram como sintomas mais frequentes a irritabilidade (89,6%) e a ansiedade (87,3%) acentuadas. O teste de qui-quadrado foi utilizado para comparar as proporções entre os fatores associados à SPM e ao TDPM, considerando p < 0,05. Os fatores de risco que tiveram associação estatística com a ocorrência de SPM/TDPM foram o índice de massa corporal (IMC) < 25 (p = 0,01) e irregularidade dos ciclos (p = 0,04).(AU)

This study evaluated the frequency of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) and associated factors among university students in health courses in Recife, Brazil. A cross-sectional study was carried out involving 649 students aged 18 to 47 years between September 2016 and March 2017. Students who agreed to participate in the study and signed a free informed consent form, was invited to answer a self-administered questionnaire with socio-demographic data, lifestyle and gynecological history, as well as issues related to the diagnostic criteria of PMS/PMDD. Most students were between 18 and 24 years old (83.2%), single (92.1%), living with parents (77.0%) and did not have a job (84.4%). The frequency of simple PMS was 23.3% and PMDD was 26.7%. Physical signs and symptoms were the most frequent (84.1%) among students with PMS. The 173 students with PMDD reported more frequent symptoms of irritability (89.6%) and anxiety (87.3%). The Pearson chi-square test was used to compare the proportions of the factors associated with PMS and PMDD, considering p < 0.05. BMI < 25 (p = 0.01) and cycle irregularity (p = 0.04) were the factors who had a statistically significant association with the occurrence of PMS/PMDD.(AU)

A study of impact of stress: examinations on menstrual cycle among medical students

Background: Premenstrual Syndrome (PMS), a common problem among adolescent girls, is associated with various physical, mental and behavioral symptoms that lead to social and occupational impairment. Stress has also been hypothesized to be an important etiologic factor. Examination stress may also be responsible for affecting the premenstrual symptoms. The objectives of this study was to study the impact of exam stress on the menstrual cycle and the relationship of perceived stress with the severity of premenstrual symptoms. Methods: This was a cross-sectional observational study conducted among female medical students of final MBBS, who were candidate of upcoming exams. They were assessed on semi structured socio-demographic and menstrual history proforma, ACOG guidelines, DSM-5 criteria, Perceived Stress Scale (PSS) and Premenstrual Symptom Screening Tool (PSST).Results: As per ACOG guidelines, 66% participants had PMS and 6% participants had PMDD according to DSM-5 criteria. On PSST total 88% participants had premenstrual symptoms and out of them 58% had mild/no PMS while 30% had moderate to severe PMS. 5% participants also fulfilled criteria for PMDD on PSST. Stress was found to be mild in 26% and moderate in 74% participants on PSS. PMS was found in 93.75% participants who had painful menstruation (dysmenorrhea) and this association was statistically significant. Data wise 73.1% participants having mild stress had PMS, while 93.2% participants having moderate stress, had PMS and this association was found to be statistically significant.  Surprisingly not a single participant consulted to any health care provider for their menstruation related problems.Conclusions: Premenstrual Syndrome is common in adolescent girls and exam stress is an important etiological factor. PMS/PMDD was found significantly higher in participants who had dysmenorrhea and moderate stress. A positive and highly significant correlation was also found between the severity of stress and severity of premenstrual symptoms.

Quality of life among university students with premenstrual syndrome / Qualidade de vida entre estudantes universitárias com síndrome pré-mesntrual

Abstract Objective To evaluate the quality of life among university students with premenstrual syndrome (PMS). Methods The cross-sectional study was conducted at the Faculdade Pernambucana de Saúde, in Recife, Brazil, between August 2016 and July 2017. Sociodemographic, gynecological, and lifestyle variables, and PMS occurrence, were investigated among 642 students. The short form of the World Health Organization Quality of Life (WHOQOL Bref) questionnaire was used to evaluate four domains of the quality of life of the students: physical, mental, social relationships, and environmental. The American College of Obstetricians and Gynecologists' criteria were used to define PMS. Results Of the 642 students, 49.9% had PMS, 23.3% had mild PMS and 26.6% had premenstrual dysphoric disorder (PMDD). Most of the students were between 18 and 24 years old, had regular menstrual cycles, and practiced physical activity. Regarding the physical and mental domains of the WHOQOL-Bref questionnaire, a statisticallysignificant difference was observed between the students who did not have and those who had mild or PMDD (p < 0.001). A difference was also found between the students who did not have PMS and those who had mild PMS in the social relationships (p = 0.001) and environmental domains (p = 0.009). Conclusion Mild PMS and PMDD are prevalent among university students on healthrelated courses, and the syndrome can affect the students' self-assessment of all the domains of quality of life.

Resumo Objetivo Avaliar a qualidade de vida entre estudantes universitárias com síndrome pré-menstrual (SPM). Métodos Foi realizadoum estudo transversal na Faculdade Pernambucana de Saúde, em Recife, no período de agosto de 2016 a julho de 2017. Foram investigadas variáveis sociodemográficas, ginecológicas, estilo de vida e a ocorrência de SPM entre 642 estudantes. Foi utilizada a forma abreviada do questionário de Qualidade de Vida da Organização Mundial da Saúde (WHOQOL Bref, na sigla em inglês) para avaliar quatro domínios da qualidade de vida: físico, mental, social e meio ambiente. Para a definição de SPM, foramconsiderados os critérios do Colégio Americano de Obstetras e Ginecologistas. Resultados Das 642 estudantes, 49,9% apresentaram SPM, sendo 23,3% SPM na forma leve e 26,6%, transtorno disfórico pré-menstrual (TDPM). A maioria das estudantes tinha entre 18 e 24 anos de idade, possuia ciclosmenstruais regulares e praticava atividade física. Em relação aos domínios físico e mental do WHOQOL-Bref, observou-se diferença estatisticamente significante entre as estudantes que não apresentavam SPM e as que apresentavam SPM, tanto a forma leve quanto o TDPM (p < 0,001). Também foi encontrada diferença no domínio "relações sociais" e "meio ambiente" entre aquelas que não tiveramTPMe as que tiveramTPMleve (p = 0,001 e p = 0,009, respectivamente). Conclusão A SPM leve e o TDPM têm alta prevalencia entre estudantes universitárias da área de saúde e pode influenciar a autoavaliação das estudantes em todos os domínios da qualidade de vida.

Premenstrual Dysphoric Disorder: Reviews of Studies in Malaysia, Measures Used, and Validation of the Daily Record of Severity of Problems

@#Premenstrual Dysphoric Disorder (PMDD) is the most severe form of Premenstrual Syndrome (PMS). It impacts the lives and productivity of women worldwide. The literature review found eight studies conducted on PMS and menstruation in Malaysia. However, none of these studies focused on PMDD and reported the utilization of psychometrically valid and reliable tools in assessing it. One of the common measures used to assess PMDD is Daily Record of Severity of Problems (DRSP). Items in DRSP are based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition. Currently, there are two published studies on the validation of DRSP and its psychometric properties which will be discussed in this paper. The review shows that an ongoing adaptation and validation study of DRSP among Malaysian is being conducted. This will contribute to the body of knowledge regarding PMDD in local settings

Premenstrual syndrome diagnosis: A comparative study between the daily record of severity of problems (DRSP) and the premenstrual symptoms screening tool (PSST) / Diagnóstico de síndrome pré-menstrual: um estudo comparativo entre o relato diário da gravidade dos problemas (DRSP) e o instrumento de rastreamento de sintomas pré-menstruais (PSST)

Abstract Objective To validate the premenstrual symptoms screening tool (PSST) in relation to the daily record of severity of problems (DRSP) for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) diagnoses. Methods A cross-sectional study with 127 women (20 45 years) with PMS complaints. The women were evaluated in terms of weight, height and body mass index (BMI). After using the primary care evaluation of mental disorders (PRIME-MD) questionnaire to exclude the diagnosis of depression, the PSST was completed and the women were instructed to fill out the DRSP for two consecutive menstrual cycles. The agreement between the two questionnaires was assessed by the Kappa (k) and the prevalence-adjusted, bias-adjusted kappa (PABAK) values. Results Two-hundred and eighty-two women met the eligibility criteria and answered the PSST. The DRSP was completed for two cycles by 127 women. The percentages of women with PMS and PMDD diagnoses by the DRSP were 74.8% and 3.9% respectively; by PSST, the percentages were41.7% and 34.6% respectively. The number of patients considered "normal" (with symptoms below the threshold for the diagnosis of PMS) was similar in both questionnaires. There was no agreement (Kappa = 0.12) in the results of PMS/ PMDD diagnosis (the PABAK coefficient confirmed this result = 0.39). The PSST had a high sensitivity (79%) and a low specificity (33.3%) for PMS/PMDD diagnosis. Conclusion The PSST should be considered a diagnostic screening tool. Positive PMS/PMDD cases by PSST should be further evaluated by DRSP to confirm the diagnosis.

Resumo Objetivo Validar o instrumento de rastreamento de sintomas pré-menstruais (PSST) em relação ao relato diário da gravidade dos problemas (DRSP) para o diagnóstico de síndrome pré-menstrual (SPM) e de transtorno disfórico pré-menstrual (TDPM). Métodos Um estudo transversal com 127 mulheres entre 20 e 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, à altura e ao índice de massa corporal (IMC). Depois de excluir o diagnóstico de depressão pelo questionário de avaliação de distúrbios mentais para atenção primária (PRIME-MD), o PSST foi respondido e as mulheres receberam orientações sobre como preencher o DRSP por dois meses. A concordância entre os dois questionários foi conduzida através do índice de Kapa (k) e pelo PABAK. Resultados Duzentos e oitenta e duas mulheres com critérios elegíveis responderam ao PSST. O DRSP foi preenchido por dois ciclos por 127 mulheres. As porcentagens de mulheres com diagnósticos de SPM e de TDPM pelo DRSP foram de 74,8% e 3,9%, respectivamente; pelo PSST, as porcentagens foram de 41,7% e 34,6%, respectivamente. O número de pacientes consideradas "normais" (com sintomas abaixo do necessário para o diagnóstico de SPM) foi similar nos dois questionários. Análises demonstraram não haver concordância entre ambos os instrumentos para os resultados diagnósticos de SPM e TDPM (Kappa = 0,12, coeficiente de PABAK = 0,39). Para o diagnóstico de SPM/TDPM, o PSST apresentou uma alta sensibilidade (79%) e baixa especificidade (33,3%). Conclusão O PSST é considerado uma ferramenta de triagem. Conclui-se que casos positivos de SPM/TDPM pelo PSST devem ser melhor investigados pelo DRSP para confirmar o diagnóstico.

Validation of the Brazilian Portuguese version of the Premenstrual Symptoms Screening Tool (PSST) and association of PSST scores with health-related quality of life

Objective: To develop and validate a Brazilian Portuguese version of the Premenstrual Symptoms Screening Tool (PSST), a questionnaire used for the screening of premenstrual syndrome (PMS) and of the most severe form of PMS, premenstrual dysphoric disorder (PMDD). The PSST also rates the impact of premenstrual symptoms on daily activities. Methods: A consecutive sample of 801 women aged ≥ 18 years completed the study protocol. The internal consistency, test-retest reliability, and content validity of the Brazilian PSST were determined. The independent association of a positive screen for PMS or PMDD and quality of life determined by the World Health Organization Quality of Life instrument-Abbreviated version (WHOQOL-Bref) was also assessed. Results: Of 801 participants, 132 (16.5%) had a positive screening for PMDD. The Brazilian PSST had adequate internal consistency (Cronbach’s alpha = 0.91) and test-retest reliability. The PSST also had adequate convergent/discriminant validity, without redundancy. Content validity ratio and content validity index were 0.61 and 0.94 respectively. Finally, a positive screen for PMS/PMDD was associated with worse WHOQOL-Bref scores. Conclusions: These findings suggest that PSST is a reliable and valid instrument to screen for PMS/PMDD in Brazilian women.

Validação da versão em português brasileiro da ferramenta de triagem de sintomas pré-menstruais e associação entre sintomas disfóricos pré-menstruais, temperamentos afetivos e qualidade de vida em uma amostra de mulheres brasileiras

O Transtorno Disfórico Pré-Menstrual (TDPM) afeta aproximadamente três a oito por cento das mulheres em idade fértil. Tal quadro é caracterizado por uma miríade demanifestações psicológicas (tristeza, irritabilidade, choro fácil, etc.) e físicas (dores nas articulações, inchaço, sensibilidade mamária etc.). O TDPM gera enorme sofrimento amulheres que apresentam esse quadro, acarretando disfunção no trabalho, nas relações interpessoais e prejuízo na qualidade de vida. A sintomatologia é cíclica e surge na fase lúteado ciclo menstrual, desaparecendo após o início da menstruação. Temperamentos afetivos são considerados manifestações subclínicas e precursores dos transtornos afetivos. Neste trabalho,buscou-se validar a Ferramenta de Triagem de Sintomas Pré-Menstruais (PSST), bem comoverificar se diferentes temperamentos afetivos e dimensões emocionais estariam associados a um rastreio positivo para TDPM em uma amostra de mulheres brasileiras e como a gravidaded estes sintomas poderia impactar de modo independente a qualidade de vida nesta amostra.Trata-se de um estudo quantitativo e transversal realizado em instituições universitárias do Estado do Ceará [Universidade Federal do Ceará – UFC, Centro Universitário Christus –Unichristus e Universidade de Fortaleza – UNIFOR, bem como no Hospital Universitário Walter Cantídio (HUWC), com estudantes universitárias, docentes e profissionais da saúde, totalizando uma amostra de 801 mulheres...

percent of women of childbearing age. This situation is characterized by a myriad ofpsychological (sadness, irritability, tearfulness, etc.) and physical (joint pain, bloating, breasttenderness, etc.) manifestations. PMDD generates significant distress to women leading topsychosocial dysfunction and impaired quality of life. The symptoms are cyclical and appearin the luteal phase of the menstrual cycle, disappearing after the onset of menstruation.Affective Temperaments are considered subclinical manifestations and intermediatephenotypes of affective disorders. In this work, we sought to validate the PremenstrualSymptoms Screening Tool (PSST). In addition, we aimed to verify if different affectivetemperaments and emotional dimensions could be associated with a positive screening forPMDD in a sample of Brazilian women and how the severity of premenstrual symptomscould independently impact the quality of life of this sample. This is a quantitative and crosssectionalstudy in universities of Ceará [Federal University of Ceará - UFC, University CentreChristus - Unichristus and University of Fortaleza – UNIFOR, as well as at the UniversityHospital Walter Cantídio (HUWC)], with university students, teachers and healt hprofessionals...

Correlation between Luteal Eating Behavior Symptom and Trait Anxiety in Premenstrual Dysphoric Disorder : A Preliminary Study / 신경정신의학

OBJECTIVES: The aim of this study was to examine the correlation between anxiety and premenstrual eating symptoms in premenstrual dysphoric disorder (PMDD). METHODS: A total of 49 women in the late luteal phase participated in this study. The psychiatric symptoms were assessed by Hamilton Rating Scale for Depression, State Trait Anxiety Inventory, and Menstrual Distress Questionnaire. Eating symptoms were assessed using the Dutch Eating Behavior Questionnaire and cocoa intake experiment. Estradiol, progesterone, and leptin were collected through venous blood. RESULTS: Participants with PMDD (n=25) showed a higher level of depression (p<0.001), trait anxiety (p=0.012), restrained eating symptoms (p=0.039), and leptin (p=0.015). Among PMDD patients in the luteal phase, trait anxiety showed correlation with emotional eating (p=0.023), alcohol (p=0.022), and unrestricted intake of cocoa (p=0.001). CONCLUSION: Our data suggest that PMDD subjects showed higher trait anxiety, depression, and difficulty in eating behavior control. Trait anxiety plays an important role in increased and uncontrolled eating symptoms during the premenstrual period and chronic course of PMDD.

Differential Association of History of Premenstrual Syndrome/ Premenstrual Dysphoric Disorder with Vasomotor Symptoms According to Menopausal Stage / 정신신체의학

OBJECTIVES: Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. METHODS: This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. RESULTS: A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). CONCLUSIONS: This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings.

Correlation between postpartum depression and premenstrual dysphoric disorder: Single center study

OBJECTIVE: To describe the prevalence and correlates of the postpartum depression and premenstrual dysphoric disorder. METHODS: One hundred sixty six women were assessed around 10th to 14th days after delivery in Gangneung Asan Hospital, Korea, from September 2011 to March 2012. We checked their risk factors for postpartum depressive disorders using the Beck Depression Inventory and the Edinburgh Postnatal Depression Scale. Premenstrual dysphoric disorder was evaluated retrospectively and was defined as having more than 5 of the following 10 symptoms: breast tenderness, bloating, headache, peripheral edema (hand and foot), depressive symptoms, anger, irritability, anxiety, oversensitivity, and exaggerated mood swings. RESULTS: The prevalence rate of postpartum depression using the Edinburgh Postnatal Depression Scale > or =10 and Beck Depression Inventory > or =10 was 13.9% (23/166). We found statistical differences (P<0.01) between the postpartum depression group and the postpartum non-depression group in smoking history, past history of psychiatric problems, and level of marital satisfaction. The prevalence rate of premenstrual syndrome (PMS) was 9% (15/166) and among 23 women in the postpartum depression group, eight were determined to have premenstrual dysphoric disorder, yielding a prevalence rate of 34.8% (8/23). Among 143 women in the postpartum non-depression group, seven were determined to have PMS, yielding a prevalence rate of 4.9% (7/143). A correlation between postpartum depression and PMS was thus found (P<0.01). CONCLUSION: PMS appears to be associated with postpartum depression. This means that a hormone-related etiology appears to be one risk factor for postpartum depression.

Efficacy and safety of a combined oral contraceptive containing drospirenone 3 mg and ethinylestradiol 20 μg in the treatment of premenstrual dysphoric disorder：a randomized, double blind placebo-controlled study / 中华妇产科杂志

Objective To compare the efficacy and safety of a new low-dose oral contraceptive pill (YAZ) containing drospirenone 3 mg and ethinylestradiol 20 μg with placebo in reducing symptoms of premenstrual dysphoric disorder (PMDD). Methods This multicenter, double-blind, randomized clinical trial consisted of 2 run-in and 3 treatment cycles (84 days) with daily symptom charting; 187 women with symptoms of PMDD were randomized to either placebo group (n=94) or YAZ group (n=93), and assessed with daily record of severity of problems scale (DRSP) and clinical global impressions scale (CGI) before, during and after the treatments. Hormones were administered for 24 days, followed by 4 days of inactive pills. Results Compared with baseline level of DRSP, both groups got improvement after treatment; the YAZ group (median-28.7, range:-82.5 to 2.3) had greater improvement than that in the placebo group (median-23.7, range:-86.0 to 11.8), while there was not significant difference (P>0.05). The main adverse effects of YAZ included intermenstrual bleeding [13% (12/93) versus 3% (3/94)], menorrhagia [9% (8/93) versus 1%(1/94)], nausea [5%(5/93) versus 4%(4/94)] and skin rash [4%(4/93) versus 2%(2/94)]. Conclusions YAZ could improve symptoms of PMDD better than placebo, while without statistic significance in this study. The most common adverse effects are intermenstrual bleeding, menorrhagia, nausea and rash.

Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series

The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do not respond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergic transmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder and one with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125 mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergic mechanisms may be involved in counteracting PMDD symptoms.

Frequency, Clinical Characteristics and Correlates of Premenstrual Syndrome in High School Students / 정신신체의학

OBJECTIVES: To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. METHODS: A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. RESULTS: The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability (78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. CONCLUSIONS: PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.

Síndrome premenstrual y trastorno disfórico premenstrual en la adolescencia / Premenstrual syndrome and premenstrual dysphoric disorder during adolescence

Hasta 85 por ciento de las mujeres en edad fértil presentan síntomas premenstruales. Sólo algunas de ellas cumplen criterios para Síndrome Premenstrual (SPM) y menos aún para Trastorno Disfórico Premenstrual (TDPM). Ambas patologías comienzan en la adolescencia y se asocian a consecuencias negativas que interfieren en el funcionamiento diario. A pesar de eso, pocas adolescentes consultan por estos síntomas y, cuando consultan, muchas veces, no reciben el diagnóstico ni el tratamiento adecuado. En este artículo se hace una revisión de la epidemiología, diagnóstico y tratamiento del SPM y del TDPM en adolescentes. Educación sobre cambios en estilo de vida, alimentación saludable y ejercicio, son las intervenciones más recomendadas en adolescentes. En cambio, en adultos habría mayor evidencia en tratamiento hormonal y con psicotrópicos.

Up to 85 percent of women of child bearing age present premenstrual symptoms. Only some of them meet criteria for Premenstrual Syndrome (PMS) and even less for premenstrual dysphoric disorder (PMDD). Both diseases begin in adolescence and are associated with negative consequences that interfere with daily functioning. Despite this, few adolescents consult for these symptoms, and when they consult, they do not get proper diagnosis and treatment. In this article we review the epidemiology, diagnosis and treatment of PMS and PMDD in adolescents. Education on lifestyle changes, healthy nutrition and exercise are the interventions most recommended in adolescents. In contrast, in adults, hormone therapy and psychotropic have greater evidence.

Premenstrual Syndrome - A Monthly Menace.

Most women feel some discomfort before or during their periods, but if the discomfort is of such a severity that starts interfering with some aspects of life: The diagnosis of premenstrual syndrome or tension (PMS or PMT) should be considered. About 80- 95% of females of childbearing age have some premenstrual symptoms. PMS affects upto 30% of women with regular menstrual cycles. Some women (about 3-8% of menstruating women) have a more severe and disabling form of PMS having a psychiatric designation called premenstrual dysphoric disorder (PMDD). The etiology of PMS remains unknown and may be complex and multifactorial, but hormones, neurotransmitters and genetic factors have a role to play. Behavioral symptoms along with physical symptoms should be present to establish a diagnosis. Certain lifestyle changes and dietary modifications along with a number of drug options can improve the quality-of-life of a patient of PMS upto a considerable extent.

Desempenho neuropsicológico e ciclo menstrual: revisão da literatura / Neuropsychological performance and menstrual cycle: a literature review

Approximately 80% of all women of reproductive age experience psychological and physical changes associated with the premenstrual phase. Cognitive alterations are among the most common complaints. In this context, studies have assessed cognitive performance across the menstrual cycle in healthy women and also in women with premenstrual syndrome (PMS). The main objective of the present study was to review the literature on cognitive function in different phases of the menstrual cycle in women of reproductive age, both healthy and with PMS, in particular premenstrual dysphoric disorder (PMDD). We searched MEDLINE and LILACS databases. A total of 27 studies were selected. The studies used heterogeneous methodologies. Most studies suggested that healthy women show small fluctuations in cognitive performance across the menstrual cycle, with low performance scores in the luteal phase for visuospatial and motor skills, attention and concentration, verbal memory, visual memory, working memory, and reaction time. Among women with PMS or PMDD, low performance scores for visuospatial and motor skills, attention and concentration, verbal memory, working memory, reaction time and impulsivity were also detected in the luteal phase. Symptoms observed in PMS/PMDD patients showed low intensity, but greater when compared with healthy women. Evidence indicates fluctuations in cognitive performance in the different phases of the menstrual cycle in healthy and PMS women, with worse performance for women with PMS/PMDD in the luteal phase. However, methodological limitations prevent us from drawing solid conclusions. Further studies are needed to investigate the impact of these cognitive fluctuations on patients' daily activities.

Cerca de 80% das mulheres em idade fértil apresentam alterações psicológicas e físicas associadas à fase pré-menstrual. Dentre as queixas mais comuns estão as alterações cognitivas. Nesse contexto, tem-se estudado o desempenho cognitivo ao longo do ciclo menstrual de mulheres com e sem síndrome pré-menstrual (SPM). O objetivo principal deste estudo foi revisar a literatura acerca do desempenho das funções cognitivas nas diferentes fases do ciclo menstrual de mulheres em idade reprodutiva, sadias ou portadoras de SPM, em particular o transtorno disfórico pré-menstrual (TDPM). Foram revisadas as bases de dados MEDLINE e LILACS. Um total de 27 estudos foram selecionados. Os estudos eram heterogêneos em suas metodologias. Em sua maioria, os trabalhos evidenciaram que mulheres sadias apresentam variações leves no desempenho cognitivo ao longo do ciclo menstrual, obtendo menor pontuação, durante a fase lútea, nas habilidades visuoespaciais e motoras, atenção e concentração, memória verbal, memória visual, memória de trabalho e tempo de reação. Entre as mulheres com SPM ou TDPM, foi identificada, na fase lútea, redução no desempenho das habilidades visuoespaciais e motoras, atenção e concentração, memória verbal, memória de trabalho, tempo de reação e impulsividade. Tais sintomas apresentaram intensidade leve, porém superior à observada em mulheres sadias. As evidências indicam a existência de variações no desempenho cognitivo ao longo das diferentes fases do ciclo menstrual de mulheres sadias ou com SPM, com desempenho cognitivo pior em mulheres com SPM/TDPM na fase lútea. Entretanto, limitações metodológicas impedem conclusões sólidas. Novos estudos são necessários para investigar o impacto dessas oscilações cognitivas nas atividades cotidianas dos pacientes.

Characteristics of PMS and PMDD in Female College Students / 정신신체의학

OBJECTIVES: We investigated the prevalence and functional impairment of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome(PMS) in young women. METHODS: A total of 1063 female college students were recruited from two urban areas(Seoul and Suwon) of Korea. Questionnaires for sociodemographic data and risk factors of PMDD, attitude about menstruation, and the Premenstrual Symptoms Screening Tool(PSST) were applied. RESULTS: The prevalence of severe moderate to severe PMS and PMDD were 16.9% and 11.7%, respectively. There were differences in the alcohol and coffee consumption, severity of menstrual cramp, and family history of PMS among the moderate to severe PMS, PMDD, and no/mild PMS groups. Although some participants did not fulfill diagnostic criteria for PMDD, they showed significant functional impairment. Participants with negative attitude about menstruation reported premenstrual symptoms more frequently than those with positive or ambivalent attitude about menstruation. CONCLUSION: These results suggest that PMS and PMDD were prevalent and associated with functional impairment in young females. Some participants reported significant functional impairments although they did not meet the full DSM-IV diagnostic criteria for PMDD. Negative attitude about menstruation was associated with more premenstrual symptoms experiences.

Síndrome pré-menstrual e transtorno disfórico pré-menstrual: atualização / Premenstrual syndrome and premenstrual dysphoric disorder: an update

A síndrome pré-menstrual é um conjunto de sinais e sintomas físicos, emocionais e comportamentais que ocorre durante a fase lútea do ciclo menstrual e atinge cerca de 40% das mulheres em idade fértil. O transtorno disfórico pré-menstrual afeta 5,8% das mulheres e é definido quando os sintomas pré-menstruais são suficientemente severos a ponto de afetar a qualidade de vida dessas pacientes em âmbito social, familiar e profissional. Há diversas opções de tratamento descritas na literatura para ambas as patologias, incluindo mudança no estilo de vida, suplementação alimentar, fitoterapia, medicamentos hormonais, supressores da ovulação, ansiolíticos, antidepressivos, entre outros. O objetivo deste artigo de revisão foi fornecer uma atualização acerca dessas doenças tão prevalentes entre as mulheres, pontuando aspectos clínicos relevantes e avaliando os tratamentos atualmente disponíveis sob a ótica da Medicina baseada em evidências.

Premenstrual syndrome is a group of physical, emotional and behavioral symptoms that happens during the luteal phase of the menstrual cycle and affects about 40% of women in their reproductive age. Premenstrual dysphoric disorder affects 5.8% of women and is defined when the premenstrual symptoms are severe enough to affect quality of life of patients in the social, familial and professional scopes. The treatment options described in literature for both diseases are vast, including change in lifestyle, diet supplementation, phytotherapy, hormonal drugs, ovulation suppressors, anxiolytics, antidepressant medications and others. The objective of this review article was to provide an update about these diseases which are among women, pointing out relevant clinical aspects and evaluating the current treatments available, according to evidence-based medicine.