Bloch M, Schmidt P J, Rubinow D R
Behavioral Endocrinology Branch, NIMH, Bethesda, MD 20892-1276, USA.
Am J Psychiatry. 1997 Dec;154(12):1741-6. doi: 10.1176/ajp.154.12.1741.
This study assessed cycle to cycle symptom stability in women with premenstrual syndrome (PMS).
Symptom ratings obtained prospectively over three or more symptomatic cycles from 16 women with PMS were analyzed. Measures of symptom severity and change were used to generate a coefficient of variation and an intraclass correlation coefficient (ICC) for each one of 14 symptoms across all cycles. In addition, symptoms were divided into three clusters, and the stability of the rank order of severity of symptoms within clusters and the correlation between symptom clusters were also calculated.
In the 65 cycles studied, mood symptoms were the most prevalent. Mood symptoms--anxiety, irritability, and mood lability--had the lowest coefficients of variation but also the lowest ICCs of all symptoms. Within their respective symptom clusters, both physical and mood symptoms showed remarkable stability across cycles of their rank order of severity, but only the mood symptom cluster was highly correlated with functional impairment.
Three mood symptoms--anxiety, irritability, and mood lability--were the most stable symptoms in this group of women with PMS. Mood and not somatic symptoms accounted for most of the functional impairment in this group of women. It is concluded that PMS is a stable syndrome that may best be viewed as part of the spectrum of recurrent mood disorders.
本研究评估经前综合征（PMS）女性患者症状在不同月经周期之间的稳定性。
分析了16名PMS女性患者在三个或更多有症状的月经周期中前瞻性获得的症状评分。使用症状严重程度和变化的测量方法，计算了所有周期中14种症状各自的变异系数和组内相关系数（ICC）。此外，将症状分为三个类别，并计算了类别内症状严重程度排序的稳定性以及症状类别之间的相关性。
在研究的65个月经周期中，情绪症状最为普遍。情绪症状——焦虑、易怒和情绪不稳定——的变异系数最低，但在所有症状中组内相关系数也最低。在各自的症状类别中，身体症状和情绪症状在不同周期的严重程度排序上均表现出显著的稳定性，但只有情绪症状类别与功能损害高度相关。
在这组PMS女性中，三种情绪症状——焦虑、易怒和情绪不稳定——是最稳定的症状。该组女性的功能损害主要由情绪而非躯体症状引起。得出的结论是，PMS是一种稳定的综合征，最好将其视为复发性情绪障碍谱系的一部分。
