SS-2 Premenstrual Syndrome Symptoms : What We Can Learn from Epidemiological Studies(ISPOG2007)
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Premenstrual Tension
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A majority of women in their reproductive years experience a variety of symptoms premenstrually that can alter behavior and well-being and affect family, friends, and working relationships. Notwithstanding its prevalence, however, research has not yet clarified this inscrutable condition, commonly known as premenstrual syndrome (PMS) or more severe PMS, premenstrual dysphoric disorder (PMDD). This comprehensive review discusses the diagnosis, epidemiology, symptoms, etiology, and the complex web of biopsychosocial factors that attends PMS.
Premenstrual dysphoric disorder
Biopsychosocial model
Etiology
Affect
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threat, although a link with the excess or extent of coronary disease is not yet proved.Preliminary age specific results in our current study of the population of north west London show this too clearly.According to tests of glucose tolerance (75 g glucose) and World Health Organisation criteria for the 269 people aged 50-69 years randomly sampled (about 75% of those eligible), over half of the Gujerati community have "ab- normal" glucose tolerance and heart disease is common.This compares with 37% in evenly sampled Afro-Caribbeans and 25% in whites.With other ethnic matters also in the BMJ may I make a further plea for the careful use of descrip- tive terms without subconscious bias?In their letter on psychiatric illness (30 July, p 359) Drs Gabrielle Milner and Gwilym Hayes describe their patients as Afro-Caribbean, Asian, and British.If the term "Asian" is unsatisfactory "British" is unacceptable; all three groups are British - "white" and "of European origin" are appropriate and without other scientifically creditable terms seem the least objectionable.
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Premenstrual disorders are characterized by numerous mood, somatic and behavioral symptoms that occur during the late luteal phase of a woman's menstrual cycle and abate soon after the onset of menses. Diagnostic criteria for premenstrual syndrome (PMS) were published by the American College of Obstetricians and Gynecologists in 2000; the American Psychiatric Association had previously established very specific diagnostic criteria for premenstrual dysphoric disorder (PMDD). Both diagnoses require 2 months of prospective symptom ratings, which can be accomplished using forms designed by individual clinicians or employing 1 of a number of validated instruments. The patient will need to provide a complete family and personal history of mental disorders and medical diseases. A thorough physical examination and certain basic laboratory tests should either identify or rule out many potential causes of the symptoms. The diseases, disorders or situations considered in the differential diagnosis of PMS and PMDD will depend on the woman's presenting symptoms. Many women with a bothersome or debilitating premenstrual disorder go undiagnosed, either because they do not report their symptoms to a clinician or because the clinician has difficulty diagnosing the disorder.
Premenstrual dysphoric disorder
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Premenstrual dysphoric disorder
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Premenstrual dysphoric disorder
Premenstrual Tension
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To review the current knowledge about the prevalence, diagnosis, and management of premenstrual syndromes in adolescents.Large epidemiologic studies addressing adolescent premenstrual disorders, clinical presentation, and comorbidity with other disorders have yet to be performed. Randomized controlled treatment trials for teens with moderate-to-severe premenstrual syndrome or the more severe affective predominant, premenstrual dysphoric disorder still are sorely lacking. This review will present an updated review of the published studies with respect to premenstrual syndrome and premenstrual dysphoric disorder in adolescents in the context of the large body of literature regarding presentation, diagnosis, and treatment in adult women.Premenstrual disorders likely start in the teen years. At least 20% of adolescents may experience moderate-to-severe premenstrual symptoms associated with functional impairment. Current treatment includes lifestyle recommendations and pharmacologic agents that suppress the rise and fall of ovarian steroids or augment serotonin.
Premenstrual dysphoric disorder
Premenstrual Tension
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Premenstrual dysphoric disorder
Functional impairment
Dysthymic Disorder
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The relationship between premenstrual affective syndrome and psychiatric disorder was investigated, using 81 women presenting to a Neurology Clinic with functional headache. Premenstrual affective syndrome was significantly associated with a history of depressive syndrome in the population studied. Patients judged to have a non-affective psychiatric disorder reported no greater frequency of definite or probable premenstrual affective syndrome than patients considered psychiatrically normal. The premenstrual occurrence or exacerbation of affective symptoms has been noted. This symptom exacerbation maybe sufficient to require hospitalization. Data presented by Coppen indicate that women with affective disorder are more likely to report the premenstrual symptom of depression than women with other psychiatric disorders. These findings suggest that there may be some relationship between depressive disorder and premenstrual affective symptoms. As part of a larger study on the personality and psychiatric correlates of functional headache, data on the relationship between depressive syndrome and premenstrual affective symptoms were obtained.
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Depression
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