Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T22:14:25.440Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of premenstrual impairment among women undergoing prospective assessment for premenstrual dysphoric disorder: a cycle-level analysis

Published online by Cambridge University Press:  14 February 2017

K. M. Schmalenberger ,
T. A. Eisenlohr-Moul ,
P. Surana ,
D. R. Rubinow  and
S. S. Girdler
K. M. Schmalenberger
Affiliation:
Heidelberg University, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Heidelberg University, Heidelberg, Germany
T. A. Eisenlohr-Moul*
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
P. Surana
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
D. R. Rubinow
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
S. S. Girdler
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
*
*Address for correspondence: T. A. Eisenlohr-Moul, PhD, University of North Carolina at Chapel Hill, 2218 Nelson Highway, Suite 3, Chapel Hill, NC 27517, USA. (Email: t.eisenlohr.moul@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Women who experience significant premenstrual symptoms differ in the extent to which these symptoms cause cyclical impairment. This study clarifies the type and number of symptoms that best predict premenstrual impairment in a sample of women undergoing prospective assessment for premenstrual dysphoric disorder (PMDD) in a research setting. Central research goals were to determine (1) which emotional, psychological, and physical symptoms of PMDD are uniquely associated with premenstrual impairment, and (2) how many cyclical symptoms optimally predict the presence of a clinically significant premenstrual elevation of impairment.

Method

A total of 267 naturally cycling women recruited for retrospective report of premenstrual emotional symptoms completed daily symptom reports using the Daily Record of Severity of Problems (DRSP) and occupational, recreational, and relational impairment for 1–4 menstrual cycles (N = 563 cycles).

Results

Multilevel regression revealed that emotional, psychological, and physical symptoms differ in their associations with impairment. The core emotional symptoms of PMDD were predictors of impairment, but not after accounting for secondary psychological symptoms, which were the most robust predictors. The optimal number of premenstrual symptoms for predicting clinically significant premenstrual impairment was four.

Conclusion

Results enhance our understanding of the type and number of premenstrual symptoms associated with premenstrual impairment among women being evaluated for PMDD in research contexts. Additional work is needed to determine whether cognitive symptoms should receive greater attention in the study of PMDD, and to revisit the usefulness of the five-symptom diagnostic threshold.

Keywords

Impairmentmenstrual cyclepremenstrual dysphoric disorderpremenstrual syndromewomen's health
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 9 , July 2017 , pp. 1585 - 1596
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

These authors served as joint first authors.

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Association: Washington, DC.Google Scholar
APA (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) . American Psychiatric Association: Washington, DC.Google Scholar
Busse, JW, Montori, VM, Krasnik, C, Patelis-Siotis, I, Guyatt, GH (2009). Psychological intervention for premenstrual syndrome: a meta-analysis of randomized controlled trials. Psychotherapy and Psychosomatics 78, 6–15.CrossRefGoogle ScholarPubMed
Dean, BB, Borenstein, JE, Knight, K, Yonkers, K (2006). Evaluating the criteria used for identification of PMS. Journal of Women's Health 15, 546–555.CrossRefGoogle ScholarPubMed
Eisenlohr-Moul, TA, Girdler, SS, Schmalenberger, KM, Dawson, DN, Surana, P, Johnson, JL, Rubinow, DR (2017). Toward the reliable diagnosis of DSM-5 premenstrual Dysphoric disorder: the Carolina Premenstrual Assessment Scoring System (C-PASS). American Journal of Psychiatry 174, 51–59.CrossRefGoogle ScholarPubMed
Endicott, J, Nee, J, Harrison, W (2006). Daily Record of Severity of Problems (DRSP): reliability and validity. Archives of Women's Mental Health 9, 41–49.CrossRefGoogle ScholarPubMed
Epperson, CN, Steiner, M, Hartlage, SA, Eriksson, E, Schmidt, PJ, Jones, I, Yonkers, KA (2012). Premenstrual dysphoric disorder: evidence for a new category for DSM-5. American Journal of Psychiatry 169, 465–475.CrossRefGoogle ScholarPubMed
Gehlert, S, Song, IH, Chang, CH, Hartlage, SA (2009). The prevalence of premenstrual dysphoric disorder in a randomly selected group of urban and rural women. Psychological Medicine 39, 129–136.CrossRefGoogle Scholar
Halbreich, U, Borenstein, J, Pearlstein, T, Kahn, LS (2003). The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 28, 1–23.Google ScholarPubMed
Hartlage, SA, Freels, S, Gotman, N, Yonkers, K (2012). Criteria for premenstrual Dysphoric disorder: secondary analyses of relevant data sets. American Medical Association Archives of General Psychiatry 69, 300–305.Google ScholarPubMed
Hylan, T, Sundell, K, Judge, R (1999). Impact of premenstrual symptoms on functioning and treatment-seeking: experience from the United States, United Kingdom, and France. Journal of Women's Health and Gender-Based Medicine 8, 1043–1052.CrossRefGoogle ScholarPubMed
Kleinstäuber, M, Witthöft, M, Hiller, W (2012). Cognitive-behavioral and pharmacological interventions for premenstrual syndrome or premenstrual Dysphoric disorder: a meta-analysis. Journal of Clinical Psychology in Medical Settings 19, 308–319.CrossRefGoogle ScholarPubMed
Linehan, MM (2014). DBT® skills training manual. Guilford Press: New York.Google Scholar
Rubinow, DR, Roy-Byrne, P, Hoban, MC, Gold, PW, Post, RM (1984). Prospective assessment of menstrually related mood disorders. American Journal of Psychiatry 141, 684–686.Google ScholarPubMed