Department of Psychology, Rhodes College, TN, USA.
Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA.
J Psychosom Res. 2014 Jan;76(1):46-55. doi: 10.1016/j.jpsychores.2013.11.002. Epub 2013 Nov 12.
Few studies have directly compared women with a menstrually related mood disorder (MRMD) with women who have suffered from depression for stress reactivity phenotypes. It is unclear whether blunted responses to stress in women with a MRMD reflect a unique phenotype of MRMDs or may be explained by a history of depression.
We assessed cardiovascular reactivity to stress in four groups: 1) Women with a MRMD without a history of depression (n=37); 2) women with a MRMD plus a history of depression (n=26); 3) women without a MRMD and without a history of depression (n=43); and 4) women without a MRMD but with a history of depression (n=20).
Women with a MRMD showed blunted myocardial (heart rate and cardiac index) reactivity to mental stress compared to non-MRMD women, irrespective of histories of depression. Hypo-reactivity to stress predicted greater premenstrual symptom severity in the entire sample. Women with a MRMD showed blunted norepinephrine and diastolic blood pressure stress reactivity relative to women with no MRMD, but only when no history of depression was present. Both MRMD women and women with depression histories reported greater negative subjective responses to stress relative to their non-MRMD and never depressed counterparts.
Our findings support the assertion that a blunted stress reactivity profile represents a unique phenotype of MRMDs and also underscore the importance of psychiatric histories to stress reactivity. Furthermore, our results emphasize the clinical relevance of myocardial hypo-reactivity to stress, since it predicts heightened premenstrual symptom severity.
鲜有研究直接比较了经前期心境障碍（MRMD）女性与应激反应表型抑郁女性。目前尚不清楚 MRMD 女性应激反应迟钝是否反映了 MRMD 的独特表型，还是可以用抑郁病史来解释。
我们评估了 4 组女性的心血管应激反应：1）无抑郁史的 MRMD 女性（n=37）；2）有 MRMD 史和抑郁史的女性（n=26）；3）无 MRMD 史和抑郁史的女性（n=43）；4）无 MRMD 史但有抑郁史的女性（n=20）。
与非 MRMD 女性相比，MRMD 女性在精神应激下的心肌（心率和心输出量）反应迟钝，无论是否有抑郁史。整个样本中，应激反应迟钝与经前期症状严重程度增加相关。与无 MRMD 女性相比，MRMD 女性的去甲肾上腺素和舒张压应激反应迟钝，但仅在无抑郁史时如此。MRMD 女性和有抑郁史的女性均报告对压力的负面主观反应大于非 MRMD 和从未抑郁的女性。
我们的研究结果支持了应激反应迟钝是 MRMD 的独特表型的观点，也强调了精神病史对应激反应的重要性。此外，我们的结果强调了心肌对压力反应迟钝的临床相关性，因为它预示着经前期症状的严重程度增加。
