The Cerebellum and Premenstrual Dysphoric Disorder.

Premenstrual Dysphoric Disorder and the Brain

In this study, we compared psychiatric symptoms, quality of life and disability in patients with pre-menstrual dysphoric disorder (PMDD) and pre-menstrual syndrome (PMS). Forty-nine women with PMDD were compared with 43 women with PMS. All participants were asked to complete a socio-demographic data collection form, a Brief Disability Questionnaire, a medical study short form-36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) forms. The patients with PMDD had higher HAD-A and HAD-D scores than the patients in PMS group (p < 0.01). No statistically significant differences were found on brief disability between two groups (p > 0.05), but both groups had medium level of brief disability. The PMDD group had a lower SF-36 scoring than the PMS group in every compared parameters (p < 0.01). PMS and PMDD may lead to brief disability, and PMDD may cause loss of quality of life and psychological problems. The evaluation of patients with PMS and PMDD pre-menstrual disorders should be more detailed.

Imaging of Eating Disorders: Multiple Techniques to Demonstrate the Dynamic Brain

Management of Premenstrual Syndrome: Green-top Guideline No. 48.

Bipolar disorder (BD) is commonly comorbid with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). However, little is known about their relationship. This study aimed to assess the impact of comorbid PMS or PMDD on the clinical characteristics of BD. A cross-sectional study was conducted on 262 women with BD. PMS and PMDD were screened with the Premenstrual Symptoms Screening Tool (PSST). Symptomatic features were assessed with Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS), and atypical features by the depressive episode section of SCID-I/P. The rates of PMS and PMDD among BD were 57.6% and 20.6% according to PSST. No significant difference in the rates of PMS and PMDD was found between BD I, BD II, and BD-NOS. Compared to BD patients without PMS or PMDD, patients with comorbid BD and PMS or PMDD were younger, more educated, had a higher risk of OCD, had an earlier age of onset, scored higher on HAMD-17 and its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and were more likely to have increased appetite and leaden paralysis. In addition, patients with comorbid BD and PMDD were less likely to experience traumatic life events, more likely to have family history of mental disorders and have inflammatory or autoimmune disease, scored higher on HMAD-17, particularly in its sub-scale of anxiety/somatization, cognitive deficit, psychomotor retardation, and sleep disturbance. Compared with BD without PMS or PMDD, BD with PMS or PMDD might be a specific subtype of BD characterized with earlier onset age, heavier genetic load, increased symptom severity, and atypical features.

Byline: Chittaranjan. Andrade Introduction The premenstrual syndrome is a common clinical condition; its prevalence depends on the threshold set for its identification. This article briefly describes its clinical features, examines issues related to its nomenclature and prevalence, considers controversies related to the diagnosis, and discusses its treatment. Special attention is paid to the use of sertraline as a treatment administered specifically within the window of symptom presence. Nomenclature Premenstrual dysphoric disorder (PMDD) has had a checkered history in the psychiatric nomenclature. Commonly referred to in lay parlance as premenstrual tension, it has been known as the premenstrual syndrome, late luteal phase dysphoric disorder, and now, premenstrual tension syndrome (International Classification of Diseases-10[sup]th revision [ICD-10]) or PMDD (Diagnostic and Statistical Manual of Mental Disorders fifth edition [DSM 5]). The current ICD-10 criteria are broad and easy to endorse;[sup][1] as a result, the current ICD concept would include a substantial proportion of women during their reproductive lifespan. In contrast, the DSM criteria are narrow and specific;[sup][1] as a result, the current DSM concept would identify only women at the severe end of the spectrum. As a striking example, in a sample of college students, the prevalence of the premenstrual syndrome was found to be 3.7% and 91.4%, depending on whether DSM or ICD criteria were applied.[sup][2] Prevalence PMDD is a modestly common condition. The prevalence of PMDD is 3%–9%.[sup][3] Similar numbers have been reported from India. In a small, early study of 62 women, Banerjee et al .[sup][4] obtained a prevalence of 6.4% for PMDD in New Delhi. In a larger, more recent study, Raval et al .[sup][2] identified a prevalence of 3.7% in a sample of 489 college girls in Bhavnagar, Gujarat. Mishra et al .[sup][5] obtained a prevalence of 37% in 100 female medical students residing in hostel facilities in Ahmedabad, Gujarat; this outlying finding may have resulted from the special nature of the sample, selection bias (symptom-free girls not returning the questionnaire), and other methodological issues. Other figures obtained were 4.7% in a sample of 1355 adolescent girls in Anand, Gujarat,[sup][6] 12.2% in a sample of 221 high school girls in Ahmedabad,[sup][7] and 10% in a sample of nursing staff and students in Wardha, Maharashtra.[sup][8] Clinical Features PMDD comprises mood symptoms such as anxiety, depression, irritability, anger, or affective lability; physical symptoms such as bloating or muscle pain; and other symptoms, such as poor concentration, decreased interests, lethargy, and changes in sleep and appetite. The symptoms require to be present across several menstrual cycles, appear in the week before the onset of a menstrual period, and diminish and disappear shortly after the onset of the period. To merit diagnostic status, the symptoms need to cause significant distress or impairment in work, social, or interpersonal spheres of functioning.[sup][9] Controversies PMDD has for long been a controversial diagnosis. It has been considered to stigmatize or marginalize women, to comprise an attempt by the pharmaceutical industry, to medicalize a normal experience, and to represent a culture-specific syndrome rather than a universally prevalent condition. These and other concerns about the research on PMDD were addressed in a detailed review by Hartlage et al .;[sup][10] the authors concluded that PMDD is a global disorder that merits full diagnostic attention. Treatment A large number of treatments have been trialed for PMDD. These include hormonal treatments, psychological treatments (from stress management to formal psychotherapy), physical treatments (e.g. yoga, aerobic exercise), mineral supplements (e.g. calcium), nutritional supplements (e. …

Premenstrual Dysphoric Disorder (PMDD) can be differentiated from Premenstrual Syndrome (PMS) by the use of the research criteria provided by the Diagnostic and Statistical Manual (DSM) IV. Indeed, PMS corresponds to mild clinical symptoms, such as breast tenderness, bloating, headache and concomitant minor mood changes, while premenstrual magnification occurs when physical and psychological symptoms of a concurrent axis I disorder get worse during the late luteal phase. Changes in appetite and eating behavior have been documented in women suffering from PMS, with an increased food intake occurring during the luteal phase. Moreover, in women with PMS, a major effect of the phase of the menstrual cycle on appetite has been documented and a high correlation with self-ratings of mood, particularly depression, has been described only in such disturbance. The aim of the present study was to analyse the clinical similarities between PMDD and Eating Disorders (in particular Bulimia Nervosa and Binge Eating Disorder). Thus, we compared the DSM III-R comorbidity, the personality dimensions and the eating attitudes in these patients, attempting to identify any relationship between groups. Twelve PMDD women (mean age 28 years), diagnosed using DSM IV criteria and premenstrual assessor form, were compared with 10 eating disorder (ED) women (6 Bulimia Nervosa, 4 Binge Eating Disorder) (mean age 25 years) and with 10 control women matched for age. The following instruments were used: (i) clinical interview with DSM III-R criteria (SCID); (ii) a psychometric study with TPQ for the evaluation of three personality dimensions (novelty seeking, harm avoidance and reward dependence); (iii) EAT/26 for the evaluation of eating attitudes. Results show that a high comorbidity for mood and anxiety disorders in PMDD and ED is well documented. Our PMDD patients share a 16.6% of comorbidity with ED, whereas such an association is present only in 2.3% of the general population. In addition, as a common clue, the personality dimension, harm avoidance, linked to a serotonin mediation is significantly more frequent in PMDD and ED than in normal controls. from the present study it seems clear that a certain degree of similarity exists between the PMDD and ED. However, whether or not these two disorders really share common ground from a physiopathological point of view still has to be clarified by more extensive studies.

Bulimia nervosa (BN) and binge-eating disorder (BED) are associated with significant health impairment. Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) comprise both psychological (disturbances in mood and affect) and physiological (bloating and changes in appetite) symptoms that may trigger binge-eating and/or purging. Female participants were drawn from the Collaborative Psychiatric Epidemiological Surveys, conducted from 2001 to 2003. Weighted multivariable logistic regression modeled the association between lifetime PMS and PMDD and lifetime odds of BN or BED. Among 8,694 participants, 133 (1.0%) had BN and 185 (1.8%) BED. Additionally, 366 (4.2%) had PMDD and 3,489 (42.4%) had PMS. Prevalence of PMDD and PMS were 17.4 and 55.4% among those with BN, 10.7 and 48.9% among those with BED and 3.4 and 59.1% among those with subthreshold BED. After adjustment for age, race/ethnicity, income, education, body mass index, age at menarche, birth control use, and comorbid mental health conditions, PMDD was associated with seven times the odds of BN (OR 7.2, 95% CI 2.3, 22.4) and PMS with two times the odds of BN (OR 2.5, 95% CI 1.1, 5.7). Neither PMDD nor PMS were significantly associated with BED. Women with PMS and PMDD have a higher odds of BN, independent of comorbid mental health conditions. PMS and PMDD may be important comorbidities to BN to consider in clinical settings, and future research should investigate whether PMS and PMDD affect the onset and duration of bulimic symptoms as well as the potential for shared risk factors across disorders. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2016; 49:641-650).

The impact of premenstrual symptoms, such as the premenstrual syndrome (PMS) and the premenstrual dysphoric disorder (PMDD), on sexual satisfaction, sexual distress, and sexual behaviors has not yet been established. To assess the correlates and risk factors of sexual satisfaction and to evaluate sexual behaviors among Polish women with premenstrual symptoms. 2,500 females, aged 18 to 45 years, from the Upper Silesian region of Poland were eligible for the questionnaire-based, prospective population study. All the inclusion criteria were met by 1,540 women who constituted the final study group. The participants were further divided into two subgroups: PMS+ (749 females) and PMS- (791 healthy subjects). Two additional subgroups were created: PMDD+ encompassing 32 subjects diagnosed with PMDD, and PMDD- comprising 32 healthy women, matched to the PMDD+ females for age, marital status, education level, employment status, place of living, and body mass index. A multiple logistic regression analysis was performed to evaluate the influence of PMS on sexual satisfaction and adjust for potential confounders. To evaluate risk factors for sexual dissatisfaction in a population of Polish females of reproductive age, diagnosed with PMS and PMDD. Women from the PMS+ group were less sexually satisfied than PMS- (77.73% vs. 88.66%, P=0.001) and reported more sexual distress (28.65% vs. 15.24%, P=0.001). There were no significant differences in sexual satisfaction between PMDD- and PMDD+. Sexual satisfaction correlated positively with a higher frequency of sexual intercourses and a higher level of education. The presence of PMS correlated negatively with sexual satisfaction, even after adjusting for potential confounders in the multivariate logistic regression model (odds ratio=0.48; confidence interval: 0.26-0.89; P=0.02). The presence of PMS is a risk factor for sexual dissatisfaction in Polish women of reproductive age.

The aims of the study were to examine the prevalence of premenstrual dysphoric disorder (PMDD), subthreshold PMDD and premenstrual syndrome (PMS) among adolescents, and to assess the nature of symptoms and the impact on daily life functions, especially for PMDD and subthreshold PMDD. A cross-sectional survey was conducted among adolescents from an urban area. Participants included 984 girls divided into the following four groups, using a premenstrual symptoms screening tool: PMDD, subthreshold PMDD, moderate/severe PMS and no/mild PMS. An Adolescent Mental Problem Questionnaire, Center for Epidemiological Studies-Depression Scale, revised Children's Manifest Anxiety Scale, and a menstrual information questionnaire were also used. Sixty-three (6.76%) of the subjects met the criteria for PMDD and 58 (6.2%) were subthreshold PMDD. The subthreshold PMDD group included 79.3% who met the symptom criteria for PMDD, but their impairment was moderate, and 21.7% who were falling short by the number of symptoms for PMDD diagnosis, though reporting severe impairment. The symptom intensity and frequency of the subthreshold PMDD subjects were similar to those in subjects with PMDD. In these two groups, 69% had moderate to severe physical symptoms. Psychiatric problems, including depression and anxiety, were higher in the PMDD and subthreshold PMDD groups than in the moderate/severe PMS and no/mild PMS group. In total, 20% of adolescents reported suffering from distressing premenstrual symptoms, and girls with PMDD and subthreshold PMDD were very similar in their symptom severity and characteristics. Prospective daily charting is needed to confirm the accurate diagnosis and management of PMDD.

Patients with schizophrenia exhibit impairments in working memory that often appear in attenuated form in persons at high risk for the illness. The authors hypothesized that deviations in task-related brain activation and deactivation would occur in persons with an at-risk mental state performing a working memory task that entailed the maintenance and manipulation of letters. Participants at ultra high risk for developing psychosis (N=60), identified using the Comprehensive Assessment of At-Risk Mental States, and healthy comparison subjects (N=38) 14 to 29 years of age underwent functional MRI while performing a verbal working memory task. Group differences in brain activation were identified using analysis of covariance. The two groups did not show significant differences in speed or accuracy of performance, even after accounting for differences in education. Irrespective of task condition, at-risk participants exhibited significantly less activation than healthy comparison subjects in the left anterior insula. During letter manipulation, at-risk persons exhibited greater task-related deactivation within the default-mode network than comparison subjects. Region-of-interest analysis in the at-risk group revealed significantly greater right dorsolateral prefrontal cortex activation during manipulation of letters. Despite comparable behavioral performance, at-risk participants performing a verbal working memory task exhibited altered brain activation compared with healthy subjects. These findings demonstrate an altered pattern of brain activation in at-risk persons that contains elements of reduced function as well as compensation.

Background: As sleep has a critical role in health and social function and also, changes in women's sleep patterns can be the first indicator of mood disorders this study was conducted to investigate the sleep disorders among women with premenstrual dysphoric disorder. Methods: In this study, using standard tools of general sleep questionnaire (GSQ) and Berlin questionnaire, sleep disorders among 67 female students with premenstrual dysphoric disorder were studied. Data was analyzed employing descriptive analysis SPSS software version 19. Results: Statistical analysis of the questionnaires showed that 25% of the sample had sleep disorders. The highest frequency belongs to daytime sleepiness (52.2%) and the lowest one belongs to snoring (3%). The findings showed that 94 percent of female college students, based on Berlin questionnaire, had low-risk for sleep apnea and only 4 patients (6%) had the risk of respiratory apnea. Conclusion: Sleep disorders are common among women with premenstrual dysphoric disorder which consequently affect the social and personal lives of women to a great extent.

P01-304-Frequency of pre-menstrual dysphoric disorder (PMDD), premenstrual syndrome (PMS) and some related factors in students of girls’ high schools of esfahan

Fish Consumption and Premenstrual Syndrome and Dysphoric Disorder in Japanese Collegiate Athletes

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are experienced in the luteal phase among women of reproductive age and affect the quality of life. This study sought to determine the prevalence and correlates of PMS and PMDD in women aged 18-25. A cross-sectional study was conducted between December 2022 and May 2023, which recruited 1125 female college students. A personal information form, the International Physical Activity Questionnaire, and the Premenstrual Syndrome Scale (PMSS) were administered. Participants who met the criteria for PMS during three consecutive menstrual cycles based on the ACOG and PMSS scores were diagnosed as having PMS. Participants who met the criteria for PMDD during three consecutive menstrual cycles based on the DSM-V were diagnosed as having PMDD. Logistic regression analysis was used to determine independent correlates of PMS and PMDD. PMS was found in 49.2% and PMDD in 48.0% of the participants. Women having a B blood group compared to those with A blood group were more likely to have PMS (OR = 151.80, 95% = 54.50-422.57). In addition, women with PMS were less likely to be physically active based on the metabolic equivalent of task score (OR = 0.99,95% = 0.98-0.99). Menstrual cycle duration was also longer among those with PMDD (OR = 1.47, 95% = 1.25-1.72), as was daily caffeine intake (OR = 1.01,95% = 1.00-1.01). PMSS score was also found to be associated with MDD (OR = 1.06,95% = 1.05-1.07). PMS and PMDD are associated with blood groups, MET scores, and other clinical characteristics that may help clinicians to identify these conditions among young women in Turkey.