Attention, response inhibition, impulsivity, and decision-making within luteal phase in women with premenstrual dysphoric disorder.

Cognitive impairment is a key feature of depressive disorder. Various forms of cognitive function have yet to be investigated in women with premenstrual dysphoric disorder (PMDD) during early luteal (EL) and late luteal (LL) phases. Therefore, we evaluated response inhibition and attention in PMDD in these two phases. We also examined the associations between cognitive functions, impulsivity, decision-making style, and irritability. There is a total of 63 female participants with PMDD and 53 controls, as determined through psychiatric diagnostic interviewing and a weekly symptoms checklist. The participants completed a Go/No-go task, Dickman's impulsivity inventory, Preference for Intuition and Deliberation scale, and the Buss-Durkee Hostility Inventory: Chinese Version-Short Form at the EL and LL phases. The women with PMDD had poorer attention in the Go trials at the LL phase and poorer response inhibition in the No-go trials at the EL and LL phases. Repeated measures analysis of variance revealed an LL exacerbation of deficit in attention among PMDD group. In addition, impulsivity negatively correlated with response inhibition at the LL phase. Preference for deliberation correlated with attention at the LL phase. Women with PMDD experienced LL declined attention and impaired response inhibition across the luteal phase. Response inhibition is linked to impulsivity. The deficit in attention links preference for deliberation among women with PMDD. These results reveal the different courses in different domains of cognitive impairment in PMDD. Further studies are required to elucidate the mechanism underlying cognitive dysfunction in PMDD.

[A nurse's experience building medical alliances for a repeatedly-hospitalized patient with bipolar disorder].

This article reports on the experience of clinical nurses in treating a patient with bipolar disorder who was re-hospitalized following a relapse attributed to poor medical alliance. During the period of nursing care (February 2 to April 7 2009), observation and interviews employed to assess the patient resulted in the three nursing diagnoses of violence risk, disorganized thinking process, and poor medical alliance. With the goal of enhancing medical alliance, an individualized plan of nursing care designed to better understanding the patient's illness history, illness and treatment attitudes, and feelings of ambivalence towards medicines was implemented in order to foster a closer nurse-patient relationship and enhance patient motivation to accept medical treatment to permit a return to a normal life as soon as possible.