The interrelation between premenstrual syndrome and major depression: Results from a population-based sample

Christine Forrester-Knauss,Sibil Tschudin,Elisabeth Zemp Stutz,Carine Weiss

doi:10.1186/1471-2458-11-795

Abstract

BackgroundResearch about the relationship between premenstrual syndrome (PMS) and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. The objectives of the study were to assess the association between premenstrual syndrome and major depression, to analyse how PMS and major depression differ and to characterise the group of women who report both PMS and major depression.MethodsData were obtained from the Swiss Health Survey 2007. Included in the analysis was data from women under the age of 55 without hysterectomy and who answered the questions on PMS symptoms. The population-based sample consisted of 3518 women. Weighted prevalence rates were calculated and relative risk ratios for PMS, major depression and women who reported both PMS and major depression, were calculated with logistic multinominal logit regression.ResultsThe prevalence of major depression was 11.3% in women screening positive for moderate PMS and 24.6% in women screening positive for severe PMS. Compared to women without any of these conditions, women who reported moderate to severe alcohol consumption had a lower risk for PMS. Women reporting use of antidepressants, and use of oral contraceptives had a higher risk for major depression compared to women without any of these conditions. Women reporting work dissatisfaction had a higher risk for PMS. A higher relative risk to report both PMS and major depression compared to women without PMS or major depression was related to factors such as high psychological distress, low mastery, psychotropic drug consumption, and low self-rated health.ConclusionsThe results suggested that women who suffer from both PMS and major depression are more impaired compared to women with only one disorder. The results further indicated that PMS and major depression are different disorders that can, however, co-occur.

Highlights

Research about the relationship between premenstrual syndrome (PMS) and major depression is limited
Some studies have shown that women with PMS or premenstrual dysphoric disorders (PMDD) have a higher percentage of past major depression than women without PMS or PMDD [10,11,18], while Hurt et al have reported contradictory results [19]: the risk of late luteal phase dysphoric disorder (LLPDD) was 14% higher in women with a past psychological disorder, it was not increased in women who reported to suffer from a major depression in the past [19]
No significant differences between the four groups were found in age, but were present in marital status and living arrangements, with the highest proportions of being unmarried and separated/divorced, living alone, and being a single parent in women with major depression

Summary

Introduction

Research about the relationship between premenstrual syndrome (PMS) and major depression is limited. This study examined the relationship between moderate to severe PMS and major depression in a population-based sample of women of reproductive age. Some authors described an overlap of symptoms such as irritability, or mood swings between severe premenstrual syndrome and depression [24]. Irritability has been described as a more prominent symptom in women with PMS or PMDD than depressed mood [12,26]. Results of studies about risk factors for depression or PMS suggested that the two disorders might have differing causes. In a longitudinal population-based twin study, it was suggested that genetic and environmental risk factors of premenstrual symptoms and major depression are not closely associated [28]. Premenstrual symptoms seem to be only to a small degree or not at all influenced by familial-environmental factors [28]

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