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)

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

Trastorno disfórico premenstrual (TDPM) / Premenstrual dysphoric disorder (PMDD)

El presente artículo trata el tema del síndrome premenstrual y su versión más grave e incapacitante: el trastorno disfórico premenstrual. Buscamos presentar los síntomas, causas y tratamientos. Resaltando la existencia de enfoques diversos. Algunos de los cuales sorprenden por su falta en efectividad, mientras que otros por lo bueno del pronóstico. Palabras claves: Trastorno Disfóricos Premenstrual, síndrome premenstrual.

This article is about premenstrual syndrome and its most serious and incapacitating version: premenstrual dysphoric disorder. We are searching for the symptoms, causes and treatments. Highlighting the existence of diverse approaches. Some of which surprise for their lack of effectiveness, while others for the good of the forecast

Korean Medication Algorithm for Depressive Disorders 2017: Third Revision

OBJECTIVE: In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. METHODS: Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies. Recommended first, second, and third-line strategies were derived statistically. RESULTS: AD monotherapy is recommended as the first-line strategy for non-psychotic depression in adults, children/adolescents, elderly adults, patient with persistent depressive disorder, and pregnant women or patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression in adult, child/adolescent, postpartum depression, and mixed features or anxious distress. Most experts recommended stopping the ongoing initial AD and AAP after a certain period in patients with one or two depressive episodes. As an MDD treatment modality, 92% of experts are considering electroconvulsive therapy and 46.8% are applying it clinically, while 86% of experts are considering repetitive transcranial magnetic stimulation but only 31.6% are applying it clinically. CONCLUSION: The pharmacological treatment strategy in 2017 is similar to that of Korean Medication Algorithm for Depressive Disorder 2012. The preference of AAPs was more increased.

Evidências de validade da escala de síndrome pré-menstrual / Preliminary pre-menstrual syndrome scale validation / Validación preliminar de la escala de síndrome pre-menstrual

Os estudos sobre variáveis exclusivamente femininas são raros na literatura nacional. O presente estudo teve como objetivo identificar evidências de validade da Escala de Síndrome Pré-menstrual (ESPm). O instrumento foi construído a partir de descrições de sintomas comumente relatados na literatura especializada e passou pelo crivo de juízes que avaliaram os itens e fatores propostos. Posteriormente, o instrumento foi aplicado em 391 trabalhadoras, por meio de um link disponibilizado virtualmente. Os indicadores de validade foram identificados, a partir da análise fatorial confirmatória, onde a melhor adequação foi apresentada por um modelo bifatorial, com menor qui-quadrado, menos graus de liberdade, além de um RMSEA de 0,04 e um CFI de 0,98. Os dois fatores que compõem a escala final (fator emocional e fator físico) contém ao todo 38 itens. (AU)

Studies on exclusively female variables are rare in national literature. The present study aimed at a preliminary validation of the Premenstrual Syndrome Scale (PmSS). The instrument was elaborated based on proposals from nursing and nutrition specialists and was reviewed by judges who evaluated the proposed items and factors. Subsequently, the instrument was applied to 391 workers through a virtual link. The validity indicators were identified from the confirmatory factor analysis, where the best fit was presented by a two-factor model, with a lower chi-square, fewer degrees of freedom, in addition to a RMSEA of 0.04 and an CFI of 0.98. The two factors that make up the final scale (emotional factor and physical factor) contain a total of 38 items. (AU)

Los estudios sobre variables exclusivamente femeninas, no son muy frecuentes em la literatura nacional. El presente estudio, tuvo como objetivo realizar una validación preliminar de la Escala de Síndrome Pre-menstrual (ESPm). El instrumento fue construído a partir de propuestas provenientes de la enfermería y nutrición y pasó por eltamiz de jueces que evaluaron los ítems y factores propuestos. Posteriormente, el instrumento fue aplicado a 391 trabajadoras, a través de um link disponibilizado virtualmente. Los indicadores de validez fueron identificados, a partir de análisis factorial confirmatorio, donde la mejor adecuación fue presentada por un modelo bifactorial, con menor qui-cuadrado, menos grados de libertad, además de un RMSEA de 0,04 y un CFI de 0,98. Los dos factores que componenla escala final (factor emocional y factor físico) contienenen total 38 ítems. (AU)

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...

Síndrome premenstrual y trastorno disfórico premenstrual / [Premenstrual syndrome and dysphoric premenstrual syndrome].

Premenstrual syndrome is characterized by physical, cognitive, affective and behavioral symptoms that occur cyclically during the luteal phase of the menstrual cycle and resolved quickly at the beginning or within few days after menstruation started. The most severe form is represented by premenstrual dysphoric disorder included in the DSM 5. Over 40

of women experience emotional symptoms such as irritability, tension, emotional lability; and physical symptoms such as breast tenderness, fatigue, and abdominal distension. It has not yet been established the underlying pathophysiological mechanism, although hypotheses related to sex hormones and the GABAergic and serotonergic regulation have been postulated. Treatment includes nonpharmacologic and pharmacologic interventions, being serotonin reuptake inhibitors the first-line treatment.

Prevalência de sintomas depressivos na perimenopausa / Depressive symptoms prevalence in the perimenopause

OBJETIVO: realizar revisão sistemática de estudos de prevalência dos sintomas depressivos na perimenopausa. MÉTODO: A pesquisa foi efetuada a partir das bases de dados MEDLINE e EMBASE. Foram incluídos estudos transversais originais com populações adultas (idade de 40 a 55 anos), no período de 1996 a 2006, que estimaram a prevalência de sintomas depressivos na perimenopausa nos idiomas: inglês, francês, espanhol e português. A seleção dos estudos pela estratégia de busca foi feita de forma independente por dois avaliadores. Foram incluídos os estudos que preencheram os seguintes critérios metodológicos: características epidemiológicas, definições de perimenopausa, instrumentos válidos utilizados para sintomas depressivos. RESULTADOS: Após a avaliação de 1.345 artigos, restaram apenas cinco que caracterizaram uma população de 11.020 mulheres com idades entre 40 e 60 anos. Constatamos que a prevalência de sintomas depressivos na perimenopausa variou entre 19 por cento e 73 por cento. CONCLUSÃO: A presente revisão sistemática mostrou expressiva variação na prevalência de sintomas depressivos na perimenopausa; ademais, não foi possível caracterizar se a sintomatologia depressiva na perimenopausa decorreu exclusivamente de flutuações hormonais observadas neste estágio da vida ou de antecedentes prévios de depressão.

OBJECTIVE: a systematic review of studies that investigated the prevalence of depressive symptoms in perimenopausal women. Method: The research was conducted in MEDLINE and EMBASE databases. Original transversal studies in from 1996 to 2006 with adult populations were enclosed (age between 40 and 55 years old) and demonstrated prevalence of depressive symptoms in the perimenopause in the following languages: English, French and Portuguese. The studies selection was conducted by two independent evaluators. The inclusion criteria were studies which fulfilled the following methodological criteria: epidemiological characteristics, perimenopause definitions and valid instruments to evaluate depressive symptoms. RESULTS: After the evaluation of 1.345 articles, 1099 were excluded since they did not satisfy the criteria of inclusion, remaining only five articles with a population of 11.020 women with ages between 40 and 60 years and, therefore, part of the studied sample enclosed in perimenopause. This study revealed a prevalence of depressive symptoms in perimenopause, which varied between 19 percent and 73 percent. CONCLUSION: The present systematic review showed substantial variation in the prevalence of depressive symptoms in perimenopause; in addition, it was not possible to characterize if the depressive symptoms in perimenopause were exclusively due to hormonal fluctuations in this stage life or if related to previous preceding moments of depression.