Brown Robin Dara, Bondy Erin, Prim Julianna, Dichter Gabriel, Schiller Crystal Edler
Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.
Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States.
Front Psychiatry. 2024 Nov 4;15:1448914. doi: 10.3389/fpsyt.2024.1448914. eCollection 2024.
Premenstrual dysphoric disorder (PMDD), a more severe manifestation of premenstrual syndrome (PMS), is characterized by emotional, behavioral, and physical symptoms that begin in the mid-to-late luteal phase of the menstrual cycle, when estradiol and progesterone levels precipitously decline, and remit after the onset of menses. Remotely monitoring physiologic variables associated with PMDD depression symptoms, such as heart rate variability (HRV), sleep, and physical activity, holds promise for developing an affective state prediction model. Switching into and out of depressive states is associated with an increased risk of suicide, and therefore, monitoring periods of affective switching may help mitigate risk. Management of other chronic health conditions, including cardiovascular disease and diabetes, has benefited from remote digital monitoring paradigms that enable patients and physicians to monitor symptoms in real-time and make behavioral and medication adjustments. PMDD is a chronic condition that may benefit from real-time, remote monitoring. However, clinical practice has not advanced to monitoring affective states in real-time. Identifying remote monitoring paradigms that can detect within-person affective state change may help facilitate later research on timely and efficacious interventions for individuals with PMDD. This narrative review synthesizes the current literature on behavioral and physiological correlates of PMDD suitable for remote monitoring during the menstrual cycle. The reliable measurement of heart rate variability (HRV), sleep, and physical activity, with existing wearable technology, suggests the potential of a remote monitoring paradigm in PMDD and other depressive disorders.
经前烦躁障碍（PMDD）是经前综合征（PMS）的一种更严重表现形式，其特征为情绪、行为和身体症状，这些症状始于月经周期的黄体中期至后期，此时雌二醇和孕酮水平急剧下降，并在月经开始后缓解。远程监测与PMDD抑郁症状相关的生理变量，如心率变异性（HRV）、睡眠和身体活动，有望开发出一种情感状态预测模型。进入和退出抑郁状态与自杀风险增加有关，因此，监测情感转换期可能有助于降低风险。包括心血管疾病和糖尿病在内的其他慢性健康状况的管理，已受益于远程数字监测模式，这种模式使患者和医生能够实时监测症状，并进行行为和药物调整。PMDD是一种慢性疾病，可能会从实时远程监测中受益。然而，临床实践尚未发展到实时监测情感状态的阶段。确定能够检测个体内部情感状态变化的远程监测模式，可能有助于推动后续针对PMDD患者的及时有效干预措施的研究。这篇叙述性综述综合了当前关于PMDD在月经周期中适合远程监测的行为和生理相关性的文献。利用现有可穿戴技术对心率变异性（HRV）、睡眠和身体活动进行可靠测量，表明远程监测模式在PMDD和其他抑郁症中的潜力。
