Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea; Korea University Research Institute of Mental Health, Seoul, Korea.
Asia Pac Psychiatry. 2014 Jun;6(2):135-44. doi: 10.1111/appy.12024. Epub 2012 Dec 26.
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.
本研究旨在调查青少年经前期心境恶劣障碍（PMDD）、阈下 PMDD 和经前期综合征（PMS）的流行率，并评估症状的性质及其对日常生活功能的影响，尤其是对 PMDD 和阈下 PMDD 的影响。
采用横断面调查方法对城区青少年进行调查。研究对象为 984 名女生，采用经前期症状筛查工具分为以下四组：PMDD、阈下 PMDD、中重度 PMS 和无/轻度 PMS。同时使用青少年心理问题问卷、流行病学研究中心抑郁量表、修订儿童 manifest 焦虑量表和月经信息问卷。
63 名（6.76%）受试者符合 PMDD 标准，58 名（6.2%）符合阈下 PMDD 标准。阈下 PMDD 组中 79.3%符合 PMDD 症状标准，但损害程度为中度，21.7%虽符合 PMDD 诊断的症状数量标准，但报告严重损害。阈下 PMDD 受试者的症状强度和频率与 PMDD 受试者相似。在这两组中，69%有中度至重度躯体症状。PMDD 和阈下 PMDD 组的精神问题，包括抑郁和焦虑，高于中重度 PMS 和无/轻度 PMS 组。
总的来说，20%的青少年报告存在令人痛苦的经前期症状，PMDD 和阈下 PMDD 女孩在症状严重程度和特征方面非常相似。需要前瞻性日常图表记录来确认 PMDD 的准确诊断和管理。
