Lifetime prevalence of psychiatric disorders in women with perimenstrual difficulties

doi:10.1016/0165-0327(86)90044-3

Journal of Affective Disorders

Volume 10, Issue 1, January–February 1986, Pages 15-19

https://doi.org/10.1016/0165-0327(86)90044-3 Get rights and content

Abstract

Fifty-eight women age 30–40 years, blind to the purpose of the study were segregated according to whether they reported none-mild or moderate-severe perimenstrual difficulties on screening interview. Lifetime prevalence of major psychiatric disorders was ascertained using the Diagnostic Interview Schedule. Women in the moderate-severe group (n = 29) showed a significantly greater lifetime prevalence of affective disorders and drug abuse. No cases of somatization disorder were detected in either group.

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Cited by (46)

Premenstrual dysphoric disorder
2009, Hormones, Brain and Behavior Online
Premenstrual dysphoric disorder (PMDD) is defined as a depressive disorder, not otherwise specified, in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. It is characterized by mood, appetite, energy, and cognitive changes that occur during the late luteal (premenstrual) phase of the menstrual cycle and remit shortly after the onset of menses. Symptoms are severe enough to interfere with functioning at home, school, or work. It occurs in an estimated 5% of women, and if left untreated, may become more severe and extend in duration over time. Based on current evidence, serotonergic dysfunction appears to be linked with its hormonal etiology, as selective serotonin reuptake inhibitors (SSRIs) demonstrate efficacy and safety. Both fluoxetine and sertraline have been approved by the Food and Drug Administration for use in PMDD. More recent studies suggest that at least among the SSRIs with longer half-lives, such as fluoxetine, the medication can be given in the second-half (luteal phase) only to achieve beneficial effects. Once the medication is stopped, however, symptoms recur in a majority of women within a few months. Other nonpharmacological approaches to treatment, such as sleep and light therapies, are being developed based on chronobiological hypotheses.
Steroid regulation of tryptophan hydroxylase protein in the dorsal raphe of macaques
1999, Biological Psychiatry
Citation Excerpt :
The lifetime prevalence of depression in women has been estimated to be as high as 21%, which is about twice the rate of men. Several lines of evidence suggest an association between depression and reproductive function (Halbreich et al 1984; MacKenzie 1986; Pearlstein 1995; Schwartz 1991; Weissman and Klerman 1985; Williams et al 1995; Yonkers and Chantilis 1995). A gender difference in depression incidence emerges in adolescence.
Background: Tryptophan hydroxylase (TPH) is the rate-limiting enzyme for the synthesis of serotonin, and serotonin is a pivotal neurotransmitter in the regulation of mood, affective behavior, pituitary hormone secretion, and numerous autonomic functions. We previously demonstrated that estradiol (E) and progesterone (P) increase TPH mRNA levels in the dorsal raphe of macaques.
Methods: This study employed western blotting and densitometric quantitation to determine whether the changes observed at the level of gene expression were manifested by changes in TPH protein expression and whether modified estrogens or progestins had actions similar to the native ligands. In addition, the effect of the antiestrogen tamoxifen was examined. Ovariectomized (ovx) rhesus and cynomolgus macaques were untreated or treated with E, P, E+P, equine estrogens (EE), medroxyprogesterone (MPA), EE+MPA, or tamoxifen. The dorsal raphe region was subjected to Western analysis.
Results: E treatment for 28 days increased TPH protein mass four to six fold over ovariectomized controls. Addition of P to the E regimen or treatment with P for 28 days after E priming did not alter TPH from E treatment alone. Treatment of ovx macaques with a low dose of P caused a two-fold increase in TPH protein. Treatment of ovariectomized macaques for 30 months with EE alone or MPA alone significantly increased TPH protein; however, unlike P, the addition of MPA to the EE regimen blocked the stimulatory effect of EE. Tamoxifen treatment significantly reduced TPH protein compared to EE and ovariectomized control animals.
Conclusion: The stimulatory effect of E and P on TPH protein in the dorsal raphe of macaques correlates with the previously observed effect at the level of mRNA expression. P had no effect on the stimulatory action of E, whereas MPA blocked the stimulatory effect of EE. Tamoxifen acted as a potent antiestrogen on TPH protein expression. If TPH protein mass influences serotonin synthesis, then these steroids will impact many autonomic systems that are regulated by serotonin.
Salivary cortisol in women with and without perimenstrual mood changes
1998, Journal of Psychosomatic Research
An increase in the activity of the hypothalamic–pituitary–adrenal axis (HPA axis) is frequently associated with major depression. During the premenstrual phase of their reproductive cycle some women experience depressive mood changes that are proposed to be of similar intensity to that experienced during periods of major depression. This study examined the secretion of cortisol, the end-product in the HPA axis, at different stages of the menstrual cycle in women with and without premenstrual depression. Women who experienced only mild physical and emotional changes in the premenstrual phase of their cycle had a significantly higher cortisol secretion on a premenstrual day (measured hourly) compared to a postmenstrual day. Those who were significantly more depressed premenstrually showed the opposite pattern of cortisol secretion with significantly lower levels on the premenstrual day compared with the postmenstrual day. Across the menstrual cycle, women who were significantly more depressed premenstrually also had lower evening cortisol levels in their premenstrual phase. The results of this study indicate that, unlike major depression where the underlying neurological changes are manifest as overactivity of the HPA axis, premenstrual depressive changes are associated with reduced HPA axis activity. Premenstrual depression may, therefore, be similar neurologically to seasonal affective disorder, which is associated with underactivity of the HPA axis.
Social subordination stress, behavior, and central monoaminergic function in female cynomolgus monkeys
1998, Biological Psychiatry
Background: Social subordination in female cynomolgus monkeys is stressful and activates the hypothalamic–pituitary–adrenal axis. In a previous experiment behavioral depression was observed in a subset of subordinates.
Methods: In the experiment reported here behavioral and physiological indicators of stress were evaluated in dominant and subordinate female cynomolgus monkeys, and brain dopaminergic activity was assessed, as reflected in the prolactin response to haloperidol, a dopamine₂ (D₂) receptor antagonist.
Results: Subordinates were aggressed more, spent more time in fearful scanning of the social environment, spent less time as the recipients of the active affiliative behavior of being groomed, had more variable heart rates in response to a novel environment, and were hypercortisolemic compared to dominants. Prolactin responses to haloperidol challenge were lower in subordinates than dominants, an observation consistent with the hypothesis that subordinate females have decreased D₂ receptor function.
Conclusions: These observations suggest that social subordination is stressful and may alter brain dopaminergic function in primates. The neurophysiological characteristics of social subordinates may contribute to their susceptibility to depression.
Behavior and physiology of social stress and depression in female cynomolgus monkeys
1997, Biological Psychiatry
The hypothesis that social subordination is stressful, and results in a depressive response in some individuals, was examined in socially housed female cynomolgus monkeys. Social status was manipulated such that half of the previously subordinate females became dominant and half of the previously dominant females became subordinate. Current subordinates hypersecreted cortisol, were insensitive to negative feedback, and had suppressed reproductive function. Current subordinates received more aggression, engaged in less affiliation, and spent more time alone than dominants. Furthermore, they spent more time fearfully scanning the social environment and displayed more behavioral depression than dominants. Current subordinates with a history of social subordination were preferentially susceptible to a behavioral depression response. The results of this experiment suggest that the stress of social subordination causes hypothalamic-pituitary-adrenal and ovarian dysfunction, and support the hypothesis that chronic, low-intensity social stress may result in depression in susceptible individuals.
Circadian rhythms of prolactin and thyroid-stimulating hormone during the menstrual cycle and early versus late sleep deprivation in premenstrual dysphoric disorder
1996, Psychiatry Research
The present study extended previous work by examining whether disturbances in the circadian rhythms of prolactin (PRL) and thyroid-stimulating hormone (TSH) distinguish patients with premenstrual dysphoric disorder (PMDD) from normal volunteers. In addition, the effects of therapeutic interventions with early and late partial sleep deprivation were explored. Both PRL and TSH levels were measured every 30 min from 18:00 h to 09:00 h during midfollicular and late luteal menstrual cycle phases in 23 PMDD patients and 18 normal volunteers. Hormone levels were measured again after a randomized crossover trial of early (sleep 03:00–07:00 h) versus late (sleep 21:00–01:00 h) partial sleep deprivation administered in two separate luteal phases. Compared with normal volunteers, PMDD patients had higher PRL concentrations, consistent with previous findings. TSH rhythms occurred earlier in PMDD than in normal subjects. PRL levels decreased and TSH levels increased with sleep deprivation compared with baseline conditions. The timing of PRL secretion shifted earlier with late sleep deprivation and later with early sleep deprivation. Although circadian disturbances of PRL and TSH were found in PMDD patients compared with normal volunteers, the therapeutic effects of early and late sleep deprivation do not appear to be mediated by correcting these disturbances.

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Lifetime prevalence of psychiatric disorders in women with perimenstrual difficulties

Abstract

Menstrual cycle symptomatology — The role of social expectancy and experimental demand characteristics

Psychosom. Med.

Psychiatric and social aspects of premenstrual complaint

Psychol. Med., Monograph Supplement

Premenstrual changes and affective disorders

Psychosom. Med.

The diversity of premenstrual changes as reflected in the Premenstrual Assessment Form

Acta Psychiat. Scand.

Severe premenstrual tension — Delineation of the syndrome

Biol. Psychiat.

Effects of acute marijuana smoking on pulse and mood states in women

Psychopharmacology

NIMH Diagnostic Interview Schedule