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经前期烦躁障碍女性的促性腺激素和强化敏感性系统。

Gonadotrophic hormone and reinforcement sensitivity systems in women with premenstrual dysphoric disorder.

机构信息

Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

出版信息

Psychiatry Clin Neurosci. 2014 Nov;68(11):785-94. doi: 10.1111/pcn.12189. Epub 2014 Jun 17.

Abstract

AIM

Behavior inhibition and behavior approach system (BIS/BAS) determine the sensitivity to aversion and rewarding stimuli, respectively. This study aimed at evaluating the BIS/BAS of premenstrual dysphoric disorder (PMDD) and effect of estrogen and progesterone on the BIS/BAS.

METHODS

Women with PMDD without treatment and control subjects were recruited from the community. The PMDD diagnosis was based on psychiatric interviewing and the result of two-menstrual-cycle follow up. A total of 67 women with PMDD and 75 control subjects were recruited and entered the final analysis. They were evaluated with BIS/BAS scale and for estrogen and progesterone levels in both premenstrual and follicular phases.

RESULTS

The results revealed that BAS score was higher among women with PMDD in both premenstrual and follicular phases. Progesterone level negatively correlated with fun-seeking, and its change in the menstrual cycle also negatively correlated to a change in fun-seeking score among women with PMDD. Women with PMDD had a higher score in BIS in the premenstrual phase and the BIS score correlated to depression, anxiety, and hostility among them.

CONCLUSION

These results suggest reward sensitivity of women with PMDD is vulnerable to the effect of progesterone change in the menstrual cycle. Furthermore, the sensitivity to aversive stimuli plays an important role involving core symptoms of PMDD. The reinforcement sensitivity of PMDD deserves further detailed study.

摘要

目的

行为抑制和行为趋近系统(BIS/BAS)分别决定了对厌恶和奖励刺激的敏感性。本研究旨在评估经前期烦躁障碍(PMDD)患者的 BIS/BAS,并评估雌、孕激素对 BIS/BAS 的影响。

方法

从社区招募未经治疗的 PMDD 患者和对照受试者。PMDD 的诊断基于精神科访谈和两个月经周期的随访结果。共招募了 67 名 PMDD 患者和 75 名对照受试者,最终纳入 67 名 PMDD 患者和 75 名对照受试者进行分析。采用 BIS/BAS 量表评估受试者,同时检测她们在经前期和卵泡期的雌、孕激素水平。

结果

结果显示,PMDD 患者在经前期和卵泡期的 BAS 评分均较高。孕激素水平与寻求乐趣呈负相关,其在月经周期中的变化也与 PMDD 患者寻求乐趣评分的变化呈负相关。PMDD 患者在经前期的 BIS 评分较高,BIS 评分与抑郁、焦虑和敌意有关。

结论

这些结果表明,孕激素变化对 PMDD 患者的奖赏敏感性有影响。此外,对厌恶刺激的敏感性在 PMDD 的核心症状中起着重要作用。PMDD 的强化敏感性值得进一步详细研究。

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