Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, 80708, Taiwan.
Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, 80708, Taiwan.
Int J Environ Res Public Health. 2020 Feb 5;17(3):988. doi: 10.3390/ijerph17030988.
Premenstrual dysphoric disorder (PMDD) demonstrates predictable, cyclic, affective and somatic symptoms that are aggravated in the late luteal phase and are resolved by menstruation. Generalized anxiety disorder (GAD) is characterized by excessive and persistant worry. The present study aims to evaluate the association between PMDD and GAD. The fluctuations of behavior inhibition, anxiety, depression, and irritability were also evaluated during the menstrual cycle among women with PMDD and healthy women. : There were 100 women diagnosed with PMDD based on a psychiatric interview and on a prospective evaluation in three menstrual cycles. A total of 96 healthy women were recruited as controls. Each individual's GAD diagnosis, behavior inhibition, behavior activation, depression, anxiety, and irritability were assessed in both luteal and follicular phases. : The odds ratio of women with GAD having PMDD was 7.65 (95% CI: 1.69-34.63) in relation to those without it. This association was partially mediated by behavior inhibition and irritability and was completely mediated by depression. Women with PMDD and GAD had higher anxiety during the luteal phase and higher PMDD severity, depression, and irritability than those without GAD in the follicular phase. There is no difference in anxiety, depression, or irritability between the luteal and follicular phases among women with PMDD and GAD. : Women with GAD were more likely to have PMDD. Anxiety, depression, and irritability symptoms in women with PMDD and GAD were not relieved in the follicular phase. Thus, GAD should be assessed for women with PMDD. Their anxiety, depression, and irritability should be intervened not only in the luteal phase, but also in the follicular phase. Depression, irritability and behavior inhibition mediated the association between PMDD and GAD. Intervening with these mediators to attenuate GAD and PMDD comorbidity should be researched in the future.
经前烦躁障碍（PMDD）表现为可预测的、周期性的、情感和躯体症状，在黄体晚期加重，并在月经期间缓解。广泛性焦虑障碍（GAD）的特征是过度和持续的担忧。本研究旨在评估 PMDD 和 GAD 之间的关联。还评估了 PMDD 妇女和健康妇女在月经周期中行为抑制、焦虑、抑郁和易怒的波动。
共有 100 名妇女根据精神病学访谈和三个月经周期的前瞻性评估被诊断为 PMDD。共招募了 96 名健康妇女作为对照组。每位个体的 GAD 诊断、行为抑制、行为激活、抑郁、焦虑和易怒在黄体期和卵泡期都进行了评估。
患有 GAD 的妇女患 PMDD 的优势比为 7.65（95%CI：1.69-34.63），而没有 GAD 的妇女则为 7.65。这种关联部分通过行为抑制和易怒来介导，完全通过抑郁来介导。在黄体期，PMDD 和 GAD 妇女的焦虑程度更高，而在卵泡期，没有 GAD 的妇女的 PMDD 严重程度、抑郁和易怒程度更高。在 PMDD 和 GAD 妇女中，焦虑、抑郁或易怒在黄体期和卵泡期之间没有差异。
患有 GAD 的妇女更有可能患有 PMDD。PMDD 和 GAD 妇女的焦虑、抑郁和易怒症状在卵泡期并未缓解。因此，应对患有 PMDD 的妇女进行 GAD 评估。不仅在黄体期，而且在卵泡期，都应干预她们的焦虑、抑郁和易怒。抑郁、易怒和行为抑制介导了 PMDD 和 GAD 之间的关联。未来应研究通过干预这些中介物来减轻 GAD 和 PMDD 共病。
