Lee Heakyong, Kim Jaehee
Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), Seoul, Republic of Korea.
Iran J Public Health. 2024 Jan;53(1):116-125. doi: 10.18502/ijph.v53i1.14688.
Positive and negative emotions have recently revealed a link with primary dysmenorrhea in adults. Among them, roles of stress and self-esteem have been less studied specially in adolescents and the direction of causality has not been clearly established. Therefore, this study investigated whether stress and self-esteem independently affect primary dysmenorrhea after adjustment for the known risk factors in adolescents. Additionally, indirect effects of stress and self-esteem were determined using mediation analyses.
This survey was conducted in adolescent girls aged 15-18 yr in metropolitan regions in South Korea in 2021. The survey included general, menstrual, and lifestyle characteristics, menstrual pain and symptom, perceived stress, self-esteem, depression, and state-trait anxiety.
Stress, depression, and anxiety were associated positively with menstrual pain and symptom (all <0.001) in adolescent girls (n=519). Self-esteem was also associated inversely with negative emotions and dysmenorrhea (all <0.001). Additionally, stress independently affected frequency and severity of menstrual symptom (both <0.05), but not pain intensity after adjustment for covariates. Stress also had indirect effect through depression and anxiety on menstrual pain and symptom. Effect of self-esteem vanished after adjustment for covariates, but indirectly reduced menstrual pain and symptom through mediations of stress, depression, and anxiety.
Mental health such as stress and self-esteem are important for managing menstrual pain and symptom in adolescents. It should be considered in managing dysmenorrhea.
近期研究表明，正负性情绪与成年人原发性痛经之间存在关联。其中，压力和自尊的作用在青少年中研究较少，因果关系方向也尚未明确确立。因此，本研究调查了在调整青少年已知风险因素后，压力和自尊是否独立影响原发性痛经。此外，还通过中介分析确定了压力和自尊的间接效应。
2021年，在韩国大城市地区对15 - 18岁的青春期女孩进行了此项调查。调查内容包括一般情况、月经情况、生活方式特征、痛经及症状、感知压力、自尊、抑郁以及状态 - 特质焦虑。
在519名青春期女孩中，压力、抑郁和焦虑与痛经及症状呈正相关（均P<0.001）。自尊也与负性情绪和痛经呈负相关（均P<0.001）。此外，在调整协变量后，压力独立影响月经症状的频率和严重程度（均P<0.05），但不影响疼痛强度。压力还通过抑郁和焦虑对痛经及症状产生间接影响。调整协变量后自尊的效应消失，但通过压力、抑郁和焦虑的中介间接减轻了痛经及症状。
压力和自尊等心理健康因素对于青少年痛经及症状的管理很重要。在痛经管理中应予以考虑。
