Padhy Susanta Kumar, Sarkar Sidharth, Beherre Prakash B, Rathi Rajesh, Panigrahi Mahima, Patil Pradeep Sriram
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Sector - 12, Chandigarh, India.
Department of Psychiatry, Jawaharlal Nehru Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Indian J Psychol Med. 2015 Apr-Jun;37(2):159-64. doi: 10.4103/0253-7176.155614.
Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) and depressive disorder are fairly common; symptoms do overlap, often under-identified and under-emphasized, particularly in rural India.
The objective was to assess the occurrence of PMS and PMDD in a sample of students and staff of a nursing college and to find their correlation with depression.
A prospective cohort study; Tertiary Care Hospital in Rural India (Wardha, Maharashtra); 118 female nursing students or staff aged between 18 and 40 years, who were likely to stay within the institution for the study period. The participants were rated on Penn daily symptom report prospectively for a period of 3-month. Those who scored positive were applied diagnostic and statistical manual of mental disorders, 4(th) edition, text revision (DSM-IV TR) criteria for PMDD; and were applied primary care evaluation of mental disorders depression screening followed by DSM-IV TR criteria for depression. Severity of depression was measured using Hamilton Depression Rating Scale.
Main outcome measures were frequency and severity of depression in individuals with PMS and PMDD and their clinical and sociodemographic correlation. The age range of the sample was 18-37 years. Some PMS symptoms were observed in 67%; diagnosis of PMDD in 10%; depressive symptoms in 28% of the sample. 46.4% of those with depressive symptoms had major depression. The diagnosis of major depression was significantly associated with the severity of PMS symptoms as well as the presence of PMDD.
Premenstrual syndrome is present in a substantial proportion of young females. Concurrent depression is increased by the severity of PMS symptoms and the presence of PMDD. Gynecologist needs to screen such subjects for depression and refer to mental-health professional early, in routine clinical practice.
经前综合征（PMS）、经前烦躁障碍（PMDD）和抑郁症相当常见；症状存在重叠，常常未被识别和重视，在印度农村地区尤为如此。
评估一所护理学院学生和教职工样本中PMS和PMDD的发生率，并找出它们与抑郁症的相关性。
一项前瞻性队列研究；印度农村的三级护理医院（马哈拉施特拉邦瓦尔达）；118名年龄在18至40岁之间的女性护理学生或教职工，她们可能在研究期间留在该机构。对参与者进行为期3个月的前瞻性每日症状报告评分。对得分呈阳性的人应用《精神障碍诊断与统计手册》第4版，修订版（DSM-IV TR）的PMDD标准；并应用《精神障碍初级保健评估抑郁筛查》，随后应用DSM-IV TR的抑郁标准。使用汉密尔顿抑郁量表测量抑郁严重程度。
主要结局指标是患有PMS和PMDD的个体中抑郁的频率和严重程度及其临床和社会人口学相关性。样本年龄范围为18 - 37岁。67%的人观察到一些PMS症状；10%被诊断为PMDD；28%的样本有抑郁症状。有抑郁症状的人中有46.4%患有重度抑郁症。重度抑郁症的诊断与PMS症状的严重程度以及PMDD的存在显著相关。
相当一部分年轻女性存在经前综合征。PMS症状的严重程度和PMDD的存在会增加并发抑郁症的几率。在常规临床实践中，妇科医生需要对这类患者进行抑郁症筛查，并尽早转诊至心理健康专业人员处。
