Premenstrual Dysphoric Disorder
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2021 ◽  
Vol 23 (11) ◽  
Christine Kuehner ◽  
Sibel Nayman

Abstract Purpose of Review In contrast to premenstrual dysphoric disorder (PMDD), premenstrual exacerbations (PMEs) of ongoing mood disorders are understudied. The aim of this review is to describe diagnostic issues, epidemiology, underlying mechanisms, and treatment for PME in unipolar depression and bipolar disorder, and to discuss clinical and research implications. Recent Findings Community-based and clinical studies estimate that in women with mood disorders around 60% report PME, while some women with bipolar disorder also show symptom exacerbations around ovulation. In general, PME predicts a more severe illness course and an increased burden. While heightened sensitivity to fluctuations of sex hormone levels across the menstrual cycle appears to contribute to PME and PMDD, the overlap of their underlying biological mechanisms remains unclear. Beneficial treatments for PMDD show less or no efficacy in PME. Pharmacological treatments for PME in mood disorders predominantly seem to profit from adjustable augmentation of treatment dosages during the luteal phase for the underlying disorder. However, the evidence is sparse and mainly based on earlier small studies and case reports. Summary Previous research is mainly limited by the lack of a clear differentiation between PME and PMDD comorbidity with mood disorders. More systematic research with uniformly defined and prospectively assessed subgroups of PME in larger epidemiological and clinical samples is needed to receive reliable prevalence estimates and information on the clinical impact of PME of mood disorders, and to uncover underlying mechanisms. In addition, larger randomized controlled trials are warranted to identify efficacious pharmacological and psychotherapeutic treatments for affected women.

2021 ◽  
Vol 12 ◽  
Emily Robertson ◽  
Caroline Thew ◽  
Natalie Thomas ◽  
Leila Karimi ◽  
Jayashri Kulkarni

BackgroundUp to 80% of reproductive-aged women experience premenstrual symptoms. Premenstrual Dysphoric Disorder (PMDD) is a severe form, affecting 2-5% of women. Combined oral contraceptive pills (COCPs) are used in the treatment of PMDD. Clinical practice suggests that a newer COCP containing nomegestrol acetate (2.5mg) and 17-beta estradiol (1.5mg), may be a suitable treatment for mood symptoms in PMDD.Materials and MethodsThis was a clinical follow-up feasibility study of women who had attended the Monash Alfred Psychiatry research centre, Women’s Mental Health Clinic, with a diagnosis of PMDD. 67% of the sample also had concurrent cPTSD, 29% co-morbid anxiety, and 20% depression. They were recommended treatment with nomegestrol acetate/17-beta estradiol. Eligible women were contacted by telephone to answer a questionnaire to assess women’s subjective response to nomegestrol acetate/17-beta estradiol, acceptability and the Depression, Anxiety and Stress Scale-21 (DASS-21) after being recommended nomegestrol acetate/17-beta estradiol. The paired-sample t-test was used to determine if there were any statistically significant differences in the DASS-21 scores over the study observation period (before and after taking nomegestrol acetate/17-beta estradiol).Results35 (74.5%) women reported a subjective positive mood response to nomegestrol acetate/17-beta estradiol, 31 (63.3%) adhered to the medication, and only 10 (20.4%) women reported side effects as the main reason for discontinuing nomegestrol acetate/17-beta estradiol. There were statistically significant reductions (p<0.05) in the overall DASS-21 scores from before women commenced nomegestrol acetate/17-beta estradiol and after commencement of treatment.ConclusionsThis preliminary study supports the acceptability and effectiveness of nomegestrol acetate/17-beta estradiol as a treatment for mood symptoms in PMDD. Further research, particularly a randomized controlled trial, is required to elucidate the effect of nomegestrol acetate/17-beta estradiol treatment on mood in PMDD.

2021 ◽  
pp. 1-16
Hossein Shareh ◽  
Maryam Ghodsi ◽  
Samira Keramati

2021 ◽  
pp. 144078332110435
Bruce MZ Cohen ◽  
Rearna Hartmann

In analysing the increasing rates of female ‘mental illness’ in neoliberal society, this article draws on Marxist and feminist theory to conceptualise psychiatry as an institution of patriarchal and capitalist power, responsible for reinforcing traditional gender roles. Through outlining the changing circumstances of women, including the recent ‘feminisation’ of the labour force, we argue that there has been a more acute need for patriarchal capitalism to curtail the emancipatory potential of women through the heightened enforcement of sex-role ideology. This is demonstrated through a profile of ‘feminised’ mental disorders which have appeared in the Diagnostic and Statistical Manual of Mental Disorders ( DSM) since 1980 – including premenstrual dysphoric disorder and female sexual interest/arousal disorder – which we argue purposely reproduce a discourse which restricts women’s advancements in paid employment while reinforcing the cliché of ‘respectable femininity’ as still primarily associated with the family and the home. We conclude the article by suggesting that, under the conditions of neoliberalism, the mental health system is becoming an increasingly powerful institution for the social control of gender.

2021 ◽  
Nader Abazari ◽  
Leila Heydarinasab ◽  
Hamid Yaghubi ◽  
Hojjatollah Farahani

Abstract Background: Premenstrual dysphoric disorder PMDD is a health difficulty that is so similar to premenstrual syndrome PMS but is more serious Many women with PMDD may also have anxiety or depression, in this way, lasting irritability or anger that may affect other people, feelings of sadness or despair, or even thoughts of suicide, feelings of tension or anxiety, panic attacks, mood swings or crying often, lack of interest in daily activities and relationships, trouble thinking or focusing, tiredness or low energy, food cravings or binge eating, trouble sleeping, feeling out of control, physical symptoms such as cramps, bloating, breast tenderness, headaches, and joint or muscle pain are some of prevalent symptoms suffer women with PMDDMethods: The present research was a randomized controlled trial. In order to control variables pain intensity and psychological distress among patients with PMDD, the participants were selected accidently from female students of Shahed University of Tehran who consulted to psychology in order to assess their premenstrual symptoms and randomly divided into two groups. Each of groups encompassed 30 women between 20 up to 35-year-old whom diagnosed by PMDD via PSST from winter 2019 to spring 2020. In this study, one group received hypnotherapy and the other group received no intervention. Results: There are significant differences between the two groups. The efficacy of the procedure of hypnotherapy in the experimental group was more than that in the control group, (sig = 0.05).Conclusion The present study findings revealed that hypnotherapy with suggestions focused on cognitive flexibility and ego strength affected pain intensity and psychological distress among females with PMDD significantly. (sig=0.05)

2021 ◽  
pp. 105426
Torbjörn Bäckström ◽  
Karin Ekberg ◽  
Angelica Lindén Hirschberg ◽  
Marie Bixo ◽  
C. Neill Epperson ◽  

Hong Xue ◽  
Zhenggang Wu ◽  
Xi Long ◽  
Ata Ullah ◽  
Si Chen ◽  

Seham M. Eldeeb ◽  
Afaf M. Eladl ◽  
Amany Elshabrawy ◽  
Amira M. Youssef ◽  
Mona H. Ibrahim

Background: Premenstrual dysphoric disorder (PMDD) is a female psychiatric disorder affecting the behaviour, cognitive abilities, mental health status and academic performance of female students. It includes: mood symptoms, behaviour symptoms and physical symptoms.Aim: To assess phenomenology, measure the prevalence of PMDD among university students and assess the relationship between PMDD and socio-demographic and personality characteristics.Setting: This study was conducted at Zagazig University, Sharqia Governorate, Egypt.Methods: A cross-sectional study was conducted from September 2020 to December 2020. It included 755 university students. They filled several questionnaires covering Diagnostic and Statistical Manual of Disorders (DSM-5) criteria to diagnose PMDD, socio-demographic, menstrual factors, physical activity and personality traits.Results: Premenstrual dysphoric disorder was found in 159 out of 755 students (21.1%). Overall, the most frequently reported premenstrual symptoms were overeating/food cravings (84.2%), fatigue/lack of energy (83.6%), depressed mood/hopelessness (82.0%) and hypersomnia (78.9%). Binary logistic regression model revealed that significantly related PMDD risk factors include: being a medical student, having a duration of menstrual bleeding ≥ 7 days, the average length of one cycle ˂ 28 days, high menstrual blood loss, presence of dysmenorrhea and positive family history of premenstrual syndrome (sister/mother). Regarding personality traits, low extroversion and agreeableness, and high neuroticism were also significant PMDD risk factors.Conclusion: Prevalence of PMDD was high among university students, especially medical students, and it can have a detrimental effect on both academic life and educational accomplishments, quality of life and daily living activities.

2021 ◽  
Vol 12 ◽  
Anastasiya Slyepchenko ◽  
Luciano Minuzzi ◽  
Benicio N. Frey

Bipolar disorder (BD) differs in its clinical presentation in females compared to males. A number of clinical characteristics have been associated with BD in females: more rapid cycling and mixed features; higher number of depressive episodes; and a higher prevalence of BD type II. There is a strong link between BD and risk for postpartum mood episodes, and a substantial percentage of females with BD experience premenstrual mood worsening of varying degrees of severity. Females with premenstrual dysphoric disorder (PMDD)—the most severe form of premenstrual disturbances—comorbid with BD appear to have a more complex course of illness, including increased psychiatric comorbidities, earlier onset of BD, and greater number of mood episodes. Importantly, there may be a link between puberty and the onset of BD in females with comorbid PMDD and BD, marked by a shortened gap between the onset of BD and menarche. In terms of neurobiology, comorbid BD and PMDD may have unique structural and functional neural correlates. Treatment of BD comorbid with PMDD poses challenges, as the first line treatment of PMDD in the general population is selective serotonin reuptake inhibitors, which produce risk of treatment-emergent manic symptoms. Here, we review current literature concerning the clinical presentation, illness burden, and unique neurobiology of BD comorbid with PMDD. We additionally discuss obstacles faced in symptom tracking, and management of these comorbid disorders.

Divya Prasad ◽  
Bianca Wollenhaupt-Aguiar ◽  
Katrina N. Kidd ◽  
Taiane de Azevedo Cardoso ◽  
Benicio N. Frey

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