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Premenstrual syndrome (PMS), dysmenorrhea, and abnormal uterine bleeding are frequent gynecological problems in adolescent girls. Studies show that sleep disorders and menstrual cycle irregularities are common conditions and indicate that they may occur together. Studies on the relationship between sleep quality and menstruation are mostly available for late adolescents (17 years and older) and young adult age groups. Our study aims to evaluate this relationship in adolescents aged 12-18. A survey study was structured and consisted of 4 sections. The first section includes anthropometric measurements and medical history of the participants; the second section includes "menstruation and menstruation symptoms history"; the third section includes "The Sleep Quality Scale and Sleep Variable Questionnaire"; and the fourth section includes the "Premenstrual Syndrome Assessment Scale" (PMSAS). Our survey was applied to those who visited the adolescent medicine outpatient clinic. The Sleep Quality Scale score was significantly lower in those with high PMSAS scores (P <.001). The participants who had dysmenorrhea and experienced other symptoms during menstruation had significantly lower SQS scores and sleep efficiency (SE) (P <.001). There was no significant difference between heavy menstrual bleeding, defined as lasting more than 7 days, requiring more than 5-6 pads/tampons per day, and SE/quality (P >.05). According to our study, dysmenorrhea and the presence of PMS may negatively affect the sleep quality of adolescents. Health professionals dealing with young people should take into account the effects of menstrual problems on sleep quality and offer appropriate support/treatment options. [ABSTRACT FROM AUTHOR]

Premenstrual disorders (PMDs) affect women's quality of life, yet the impact on romantic relationships remains unclear. This study aimed to examine the association between severe PMDs and relationship disruption and initiation. We conducted a prospective cohort study of 15,606 women during 2009–2021 in Sweden. PMDs were assessed with the modified Premenstrual Symptom Screening Tool at baseline (one-time retrospective self-report), while relationship status was obtained from national population registers during follow-up. Poisson regression was employed to assess the risk of relationship change. At baseline (mean age 33.5 years), 1666 (10.6 %) women met the criteria for severe PMDs. All women were followed for 9.1 years on average for any change of relationship status. Among married/cohabiting women, PMDs were positively associated with relationship disruption (Incidence risk ratio, IRR =1.21, 95 % CI: 1.01–1.43, p = 0.03). A more pronounced association was suggested for premenstrual dysphoric disorder (IRR = 1.22, 95 % CI: 1.01–1.45, p = 0.03) than severe premenstrual syndrome (IRR = 1.01, 95 % CI: 0.43–1.96, p = 0.98) and among women without depression/anxiety (IRR = 1.21, 95 % CI: 1.00–1.47, p < 0.05) than among those with (IRR = 0.99, 95 % CI: 0.61–1.54 p = 0.96) and IRR = 1.01, 95 % CI: 0.57–1.72, p = 0.97). Among single women, a null association was found between PMDs and relationship initiation (IRR = 1.05, 95 % CI: 0.95–1.15, p = 0.32). PMDs were not assessed using prospective symptom charting. Married/cohabiting women with probable severe PMDs have an increased risk of relationship disruption. PMDs were not associated with relationship initiation in single women. Healthcare professionals should recognize relationship challenges in women with severe PMDs, and they may require support to maintain healthy relationships. • It's unknown if chronic and cyclic symptoms of premenstrual disorders (PMDs) affect relationship disruption and initiation. • In a Swedish cohort, married or cohabiting women with severe PMDs have an increased risk of relationship disruption. • Single women with severe PMDs did not have a lower rate of relationship initiation. • Partnered women with severe PMDs may require more substantial professional support than currently recognized. [ABSTRACT FROM AUTHOR]

Premenstrual Syndrome significantly affects young women's quality of life, encompassing psychological and clinical symptoms. The aim of this study is to develop a comprehensive and reliable Premenstrual Syndrome Quality of Life Scale and identify factors that affect women's quality of life. A methodological and descriptive study was conducted to develop a Premenstrual Syndrome Quality of Life Scale in three phases. Initially, a literature review and qualitative interviews were conducted to generate an item pool. In the second phase, the validity and reliability of the scale were tested. Exploratory Factor Analysis, Confirmatory Factor Analysis were used to confirm the validity and Cronbach's Alpha coefficient was calculated for reliability. In the final phase, the psychometric properties of the scale were evaluated. A 28-item scale was developed in phase one. In Phase two 260 women were participated. Factor analysis confirmed the scale's validity with a KMO measure of 0.837 and significant Bartlett's Sphericity Test (p < 0.000). Confirmatory factor analysis indicated a good fit for the scale. Reliability analysis showed high reliability for the overall scale and subscales. Phase three included 212 participants diagnosed with premenstrual syndrome. There are no significant correlations between age, menarche age, and overall PMS Quality-of-Life scores. However, higher PMS severity and urban living negatively impact quality of life (p < 0.05). The Premenstrual Syndrome Quality of Life Scale provides a holistic assessment of premenstrual syndrome impact on women's lives, addressing physical, emotional, and social dimensions. • The premenstrual syndrome is a multifaceted condition that affects women of reproductive age physically and emotionally. • PMS-QoL was developed to offer a comprehensive perspective on the challenges women face during premenstrual syndrome. • Health professionals can use PMS-QoL to improve interventions to meet women's needs during this period. • The PMS-QoL scale consists of 22 items divided into three subdimensions: physical, emotional, and social well-being. [ABSTRACT FROM AUTHOR]

Selective serotonin reuptake inhibitors (SSRI) are the primary treatment for premenstrual mood symptoms and particularly effective in reducing reactive aggression in the forms of irritability and anger. The present study examined whether behavioral responses in laboratory measures of reactive aggression are influenced by medication with the SSRI escitalopram in women reporting high levels of premenstrual irritability/anger. Participants (N = 34) rated the cardinal mood symptoms of premenstrual dysphoric disorder over three menstrual cycles. During the second and third cycles, participants received escitalopram (20 mg) or placebo in a single-blind, cross-over design. In the luteal phase of the intervention cycles, participants completed two aggression tasks: The Anger-Infused Ultimatum Game (AI-UG) and the Point Subtraction Aggression Paradigm (PSAP). Additionally, they rated expression and control of anger using the State-Trait Anger Expression Inventory-2 (STAXI-2) once in the luteal phase and once in the follicular phase. While irritability/anger was reduced in the treatment (vs. placebo) cycle, no effect of escitalopram was detected in the PSAP. Escitalopram decreased reactive aggressive behavior in the AI-UG but only for a subset of participants who experienced a sharp premenstrual rise in outwardly expressed anger and/or did not experience a premenstrual rise in inwardly expressed anger. The participants' symptoms were based on the severity of only premenstrual irritability/anger, limiting the generalizability to the broader group of PMDD patients. The results suggest that the behavioral consequences of severe premenstrual irritability/anger are not easily captured by traditional measures of reactive aggression and underline the importance of considering individual differences in symptom expression. • SSRI efficiently reduces premenstrual irritability/anger. • No differences in aggressive behavior were detected during SSRI (vs placebo). • Individual variations in anger expression may affect SSRI's effect on aggression. [ABSTRACT FROM AUTHOR]

The aim of this study was to find out how well pomegranate use affects quality of life and PMS symptoms. This randomised controlled trial (Clinical trial number: NCT06201702) was conducted in a city in the western region of Turkey, reaching women with PMS through social media announcements. Data were collected between 2 January 2024 and 15 May 2024. In the study of 60 participants (intervention group: 30, control group: 30), the intervention group was given pomegranate exrat supplementation for 2 cycles, while the control group did not receive any intervention. The research data were collected through a descriptive information, Premenstrual Syndrome Scale and World Health Organisation Quality of Life Scale. IBM SPSS Version 23 software was used for data analysis. Chi-square test, paired sample t -test and independent sample t-test were used. P -value <.05 was considered statistically significant. When the intervention and control groups were compared in terms of premenstrual syndrome scores, a statistically significant difference was found and it was observed that symptoms decreased significantly in the intervention group after the intervention (p <.05). However, no statistically significant change was observed in the control group (p >.05). When the quality of life scores after the intervention were evaluated, it was seen that the social quality of life of the intervention group was higher than the control group (p <.05). This study shows that pomegranate may be a potential natural solution, especially in reducing PMS symptoms, and may also be effective in improving social quality of life. • This study examined the effect of pomegranate use on PMS symptoms and quality of life. • Pomegranate was found to have a statistically significant effect on PMS symptoms. • Pomegranate had no statistically significant effect on quality of life. • Pomegranate may be a suitable natural remedy, especially in reducing PMS symptoms [ABSTRACT FROM AUTHOR]

This study was carried out to determine the effect of progressive muscle relaxation exercises (PMR) on premenstrual syndrome (PMS) symptoms. The study was designed in a single-blind randomized controlled type. The study was conducted in a hospital in Western Türkiye. Seventy-nine single women who experienced PMS who met the inclusion criteria were randomly assigned to the experimental group in which PMR would be applied, and the control group to continue their routine coping habits regarding PMS. PMR were applied to the experimental group every day for 8 weeks. At the end of 8 weeks, the experimental and control groups were re-evaluated with the Premenstrual Syndrome Scale (PMSS). At the beginning of the study, it was observed that the individual, health characteristics and PMSS mean scores of the women in the experimental and control groups were similar (p > 0.05). At the end of eight weeks, it was seen that the mean PMSS score of the experimental group was lower than that of the control group, and the difference was statistically significant (p < 0.001). When in-group comparisons were made at the end of the exercise program, no significant difference was found in the mean PMSS score of the control group compared to the beginning (p > 0.05). The PMSS score of the experimental group decreased significantly and the difference was statistically significant (p < 0.001). In this study, it was seen that PMR were effective in improving PMS. • Premenstrual syndrome is a condition that women worldwide can experience. • Premenstrual syndrome manifests with various symptoms. • Progressive relaxation exercises can provide a healing effect in premenstrual syndrome. • Progressive relaxation exercises can be used safely by women in the management of premenstrual syndrome. [ABSTRACT FROM AUTHOR]

This systematic review aimed to summarize the most recent data on changes in brain structure and function in premenstrual dysphoric disorder (PMDD) as well as elucidate the possible correlations between these findings and symptom severity. Articles published in PubMed, EMBASE, ScienceDirect, PsycInfo, Web of Science, and Scopus from inception until April 2023 were systematically reviewed according to the PICO framework: population (women with PMDD), intervention (neuroimaging study), control (healthy subjects), and outcome (neuroimaging changes). In total, 1026 individuals were included from controlled (n = 22) and non-controlled (n = 2) trials. Among them, 608 had PMDD, and 418 were healthy controls. Different neuroimaging methods were addressed, such as task-based functional magnetic resonance imaging (MRI), resting-state functional MRI, proton magnetic resonance spectroscopy, diffusion tensor imaging, proton emission tomography, and structural MRI. Despite the absence of consensual results, several brain structures have been implicated in PMDD, including the prefrontal cortex, amygdala, hippocampus, insula, basal ganglia, and cerebellum. In addition, some brain changes are related to the intensity of symptoms and phases of the menstrual cycle, such as the correlation between depressive symptoms and increased serotonin transporter binding potential in the midbrain during the luteal phase. • Current findings suggest an impairment in the functioning of top-down emotional control in patients with PMDD. • Patient with PMDD demonstrates structural impairment of corticolimbic connections. • PMDD exhibited corticocortical hypoconnectivity and subcortical hyperconnectivity. • From the periovulatory to the premenstrual phase, patients with PMDD increased availability of the serotonin transporter. • Patients with PMDD have altered gray matter volume in the amygdala, hippocampus, striatum, and cerebellum. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) is hypothesized to stem from maladaptive neural sensitivity to ovarian steroid hormone fluctuations. Recently, we found thinner cortices in individuals with PMDD, compared to healthy controls, during the symptomatic phase. Here, we aimed at investigating whether such differences illustrate state-like characteristics specific to the symptomatic phase, or trait-like features defining PMDD. Patients and controls were scanned using structural magnetic resonance imaging during the mid-follicular and late-luteal phase of the menstrual cycle. Group-by-phase interaction effects on cortical architecture metrics (cortical thickness, gyrification index, cortical complexity, and sulcal depth) were assessed using surface-based morphometry. Independently of menstrual cycle phase, a main effect of diagnostic group on surface metrics was found, primarily illustrating thinner cortices (0.3 < Cohen's d > 1.1) and lower gyrification indices (0.4 < Cohen's d > 1.0) in patients compared to controls. Furthermore, menstrual cycle-specific effects were detected across all participants, depicting a decrease in cortical thickness (0.4 < Cohen's d > 1.7) and region-dependent changes in cortical folding metrics (0.4 < Cohen's d > 2.2) from the mid-follicular to the late luteal phase. Small effects (d = 0.3) require a larger sample size to be accurately characterized. These findings provide initial evidence of trait-like cortical characteristics of the brain of individuals with premenstrual dysphoric disorder, together with indications of menstrual cycle-related variations in cortical architecture in patients and controls. Further investigations exploring whether these differences constitute stable vulnerability markers or develop over the years may help understand PMDD etiology. • Changes in cortical architecture throughout the menstrual cycle • Thinner cortices and less gyrification in premenstrual dysphoric disorder • No state-like cortical characteristics of premenstrual dysphoric disorder [ABSTRACT FROM AUTHOR]

In the transition phase from adolescence to adulthood, premenstrual syndrome (PMS) occurs more commonly, with a variety of symptoms. The occurrence of PMS may be the result of a combination of demographic, physiological, psychological and sociological factors. This study aimed to identify the central symptoms of PMS, and explored the complex influencing factors especially the one-to-one inter-relationships factors with specific symptoms. This is a cross-sectional study conducted in mainland China. 3458 young adult women were assessed. Using the Premenstrual Syndrome Scale (PSS) to assess the PMS, and PSS score was over 6 divided into PMS group, and vice versa. Influencing factors were assessed by a set of self-reported questionnaire. Network analysis was used to examined the interplay of PMS, whilst also considering the influencing factors of PMS. In summary, 1479 participants were in PMS group. Anxiety had the highest strength centrality (1.12/1.09), shown higher centrality in the both network. Swelling of the hands or feet also shown higher strength centrality (0.89) in PMS group. PMS is associated with a higher history of dysmenorrhea, and neurotic personality. Neurotic personality - depressed mood/nervousness (0.27/0.23), history of dysmenorrhea - abdominal distension (0.21), had significantly higher weight than other edges in PMS group. Anxiety was the most central symptom in the network, and was closely associated with other symptoms like depressed mood, which provided additional evidence for the centrality of emotional features in PMS. Moreover, the influencing factors of PMS combined demographic, physiological, psychological, and sociological factors. According to the central symptoms and factors affecting the specific PMS symptoms in young adult women, targeted intervention is helpful to prevent and alleviate PMS. Cross-sectional design cannot infer the directionality of the associations between variables. All data is self-reported with recall bias and the edge weights across the constructs of influencing factors and PMS were fairly small. • Anxiety was the most central symptom in the network, and was closely associated with other symptoms like depressed mood. • The influencing factors of PMS combined demographic, physiological, psychological, and sociological factors. • Targeted interventions are based on the central symptoms and factors affecting the specific PMS symptoms. [ABSTRACT FROM AUTHOR]

Asthma is a common chronic disease in pediatric patients, and perimenstrual asthma (PMA), refers to the worsening of asthma symptoms during the perimenstrual period, mainly reported in adult women. However, there is limited information regarding the exacerbation of symptoms in the presence of premenstrual disorders (PMDs) in adolescents. The aim of this pilot observational study was to investigate the frequency and potential association of PMA and PMDs in a clinical sample of adolescents with asthma. The study included 50 adolescents (aged 12-18 years, mean 16.08 ± 2.35) with asthma and at least 2 years of gynecological age. The participants completed the Asthma Control Test (ACT) to assess asthma control (considered pathological if ACT score < 20) and the modified Premenstrual Symptoms Screening Tool for Adolescents (PSST-A) to evaluate PMDs. A total of 75.5% of adolescents reported PMA. The prevalence of premenstrual symptoms did not significantly differ between the PMA and no-PMA group. Among the study sample, 38.7% experienced symptoms indicative of moderate/severe premenstrual syndrome, and 8.1% exhibited symptoms of premenstrual dysphoric disorder. Compared with the no-PMA group, patients with PMA showed a significant impairment in daily and home activities (P =.03 and P =.02, respectively) and exhibited a difference in the frequency of asthma symptoms (P <.001) and medication use (P ≤.01). Perimenstrual worsening of asthma symptoms may be common in adolescents with a severe form of asthma. Prospective data collection through menstrual diaries is necessary to further explore the association between PMA and PMDs. Identifying early risk factors for PMA could facilitate the development of preventive strategies and early interventions for adolescents with asthma. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder is characterised by symptoms confined to the premenstrual phase of the menstrual cycle. Confirmed diagnosis requires prospective monitoring of symptoms over two cycles, otherwise the diagnosis is provisional. We aimed to measure the point prevalence of premenstrual dysphoric disorder. We searched for studies of prevalence using MEDLINE, EMBASE, PsycINFO and PubMed. For each study, the total sample size and number of cases were extracted. The prevalence across studies was calculated using random effects meta-analysis with a generalised linear mixed model. Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Pre-registration was with PROSPERO (CRD42021249249). 44 studies with 48 independent samples met inclusion criteria, consisting of 50,659 participants. The pooled prevalence was 3.2 % (95 % confidence intervals: 1.7 %–5.9 %) for confirmed and 7.7 % (95 % confidence intervals: 5.3 %–11.0 %) for provisional diagnosis. There was high heterogeneity across all studies (I2 = 99 %). Sources of heterogeneity identified by meta-regression were continent of sample (p < 0.0001), type of sample (community-based, university, high school) (p = 0.007), risk of bias (p = 0.009), and method of diagnosis (p = 0.017). Restricting the analysis to community-based samples using confirmed diagnosis resulted in a prevalence of 1.6 % (95 % confidence intervals: 1.0 %–2.5 %), with low heterogeneity (I2 = 26 %). A small number of included studies used full DSM criteria in community settings. The point prevalence of premenstrual dysphoric disorder using confirmed diagnosis is lower compared with provisional diagnosis. Studies relying on provisional diagnosis are likely to produce artificially high prevalence rates. • Prospective daily symptom ratings are needed for confirmed diagnosis of PMDD. • Point prevalence was pooled across studies using random effects meta-analysis. • The point prevalence in community-based samples was 1.6 % (95 % CI: 1.0 %–2.5 %). [ABSTRACT FROM AUTHOR]

The interplay between ovarian hormones, stress, and inflammatory markers in developing premenstrual dysphoric disorder (PMDD) remains inadequately understood. This study investigated the associations of dynamic changes in the levels of estrogen, progesterone, cortisol, brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) with PMDD during the luteal phase of the menstrual cycle. A total of 58 women with PMDD and 50 healthy women were recruited in this study. These women's estrogen, progesterone, cortisol, BDNF, and VEGF levels were evaluated during the preovulation (PO), mid-luteal (ML), and late-luteal (LL) phases. Furthermore, the severity of P MDD symptoms, depressive symptoms, perceived stress, inattention, craving for sweet foods, and fatigue was assessed. The findings revealed that women with PMDD with higher levels of progesterone during the ML or LL phase or a greater increase (ML−PO) or higher sum (ML + LL) of luteal progesterone level exhibited a greater increase in PMDD symptoms during the luteal phase than did the healthy controls. Furthermore, women with PMDD exhibited higher cortisol levels during the LL phase than did the controls. The BDNF level was negatively correlated with PMDD severity. Furthermore, BDNF and VEGF levels were negatively correlated with inattention and craving for sweet foods among women with PMDD. These results suggest an association between progesterone and the exacerbation of PMDD symptoms during the LL phase. Women with PMDD have relatively high cortisol levels during the LL phase. Future investigations with experimental designs or larger sample sizes are warranted to verify the roles of progesterone and cortisol in the development of PMDD. • Women with PMDD with a greater increase in progesterone level exhibited a greater increase in PMDD symptoms during the luteal phase. • Women with PMDD exhibited higher late-luteal cortisol levels than controls. • The BDNF level was negatively correlated with PMDD severity. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) is characterized by affective, cognitive, and physical symptoms, suggesting alterations at the brain network level. Women with PMDD demonstrate aberrant discrimination of facial emotions during the luteal phase of the menstrual cycle and altered reactivity to emotional stimuli. However, previous studies assessing emotional task-related brain reactivity using region-of-interest or whole-brain analysis have reported conflicting findings. Therefore, we utilized both region-of-interest task-reactivity and seed-voxel functional connectivity (FC) approaches to test for differences in the default mode network, salience network, and central executive network between women with PMDD and control participants during an emotional-processing task that yields an optimal setup for investigating brain network changes in PMDD. Twenty-four women with PMDD and 27 control participants were classified according to the Daily Record of Severity of Problems. Participants underwent functional magnetic resonance imaging scans while completing the emotional face-matching task during the midfollicular and late-luteal phases of their menstrual cycle. No significant between-group differences in brain reactivity were found using region-of-interest analysis. In the FC analysis, a main effect of diagnosis was found showing decreased default mode network connectivity, increased salience network connectivity, and decreased central executive network connectivity in women with PMDD compared with control participants. A significant interaction between menstrual cycle phase and diagnosis was found in the central executive network for right posterior parietal cortex and left inferior lateral occipital cortex connectivity. A post hoc analysis revealed stronger FC during the midfollicular than the late-luteal phase of PMDD. Aberrant FC in the 3 brain networks involved in PMDD may indicate vulnerability to experience affective and cognitive symptoms of the disorder. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) disrupts the lives of millions of people each month. The timing of symptoms suggests that hormonal fluctuations play a role in the pathogenesis. Here, we tested whether a heightened sensitivity of the serotonin system to menstrual cycle phase underlies PMDD, assessing the relationship of serotonin transporter (5-HTT) changes with symptom severity across the menstrual cycle. In this longitudinal case-control study, we acquired 118 [11C]DASB positron emission tomography scans measuring 5-HTT nondisplaceable binding potential (BP ND) in 30 patients with PMDD and 29 controls during 2 menstrual cycle phases (periovulatory, premenstrual). The primary outcome was midbrain and prefrontal cortex 5-HTT BP ND. We tested whether BP ND changes correlated with depressed mood. Linear mixed effects modeling (significant group × time × region interaction) showed a mean increase of 18% in midbrain 5-HTT BP ND (mean [SD] periovulatory = 1.64 [0.40], premenstrual = 1.93 [0.40], delta = 0.29 [0.47]: t 29 = −3.43, p =.0002) in patients with PMDD, whereas controls displayed a mean 10% decrease in midbrain 5-HTT BP ND (periovulatory = 1.65 [0.24] > premenstrual = 1.49 [0.41], delta = −0.17 [0.33]: t 28 = −2.73, p =.01). In patients, increased midbrain 5-HTT BP ND correlated with depressive symptom severity (R 2 = 0.41, p <.0015) across the menstrual cycle. These data suggest cycle-specific dynamics with increased central serotonergic uptake followed by extracellular serotonin loss underlying the premenstrual onset of depressed mood in patients with PMDD. These neurochemical findings argue for systematic testing of pre–symptom-onset dosing of selective serotonin reuptake inhibitors or nonpharmacological strategies to augment extracellular serotonin in people with PMDD. [ABSTRACT FROM AUTHOR]

Menstruation-induced psychosis (MIP) is a rare disorder with limited documentation in the medical literature. Most cases have been described in case reports, although multiple literature reviews have demonstrated the relationship between menses and psychosis. Here, we describe 2 episodes of rapid-onset psychosis in a healthy 15-year-old girl. Written informed consent was obtained from the patient and their father. On first evaluation, autoimmune encephalitis was the leading diagnosis of consideration. The patient received intravenous immune globulin, returning to baseline within 24 hours of administration. Extensive neurological workup was unrevealing, aside from mild cerebrospinal fluid pleocytosis, serum anti-thyroid peroxidase (TPO) antibodies, and a fluid-attenuated inversion recovery (FLAIR) splenial lesion on magnetic resonance imaging. Psychotic symptoms began around the start of the patient's menstrual cycle, and both episodes were less than 1 week in duration. This report reviews the characteristics of MIP, details a case of recurrent psychosis that fits these characteristics, and adds a well-documented case to the growing series of reports. Given the rarity of MIP, it is essential to thoroughly document such cases. This case provides an example of the clinical presentation and disease course for pediatric patients presenting with MIP, and may serve as a reference for future work in understanding MIP. MIP is characterized by psychotic symptoms of acute onset and short duration that occur in association with the menstrual cycle. 1,2 MIP can present in any individual capable of menstruation, including those who do not identify as female. Per previous reports, patients generally have no history of mental illness prior to their first psychotic episode and completely recover their baseline functioning. 1 In this case, the patient's presentation is consistent with the characteristics previously described for MIP. 1 [ABSTRACT FROM AUTHOR]

Over 2 decades of research indicate the significance of racial or ethnic disparities in mental illness in the United States. However, minoritized racial or ethnic groups tend to report overall lower prevalence rates of psychiatric disorders than White adults, although this varies depending on gender and race or ethnicity. We conducted a rigorous and systematic narrative synthesis on the differences in the prevalence rates and symptoms that differ across racial or ethnic women in depression, anxiety, eating disorders, and premenstrual syndrome or premenstrual dysphoric disorder. Seven systematic reviews and meta-analyses that examined racial/ethnic differences in depression and eating disorders were included. No review that examined racial/ethnic differences in anxiety or premenstrual syndrome or premenstrual dysphoric disorder met inclusion criteria. Methodological quality of the reviews, which was determined by the Assessment of Multiple Systematic Reviews criteria, revealed that the results of 5 reviews were rated as critically low confidence, one review was rated as low confidence, and one review was rated as high confidence. Findings were inconsistent across systematic reviews and meta-analyses because of the methodological differences in the original studies. Overall, racially or ethnically minoritized women generally report lower prevalence rates in depressive and eating disorders than the White women; however, they exhibit different or greater symptom presentation that could influence prevalence estimates depending on the diagnostic criteria followed. Methodological considerations are provided to strengthen the literature on racial or ethnic mental health disparities in women. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) and severe premenstrual syndrome (PMS) exert profoundly adverse effects on quality of life. We surveyed psychiatrists and clinical psychologists in Japan to determine their understanding and practice of diagnosing PMDD/PMS. We targeted psychiatrists and clinical psychologists working at health administration facilities of universities in Japan who treat female patients with depressive symptoms in their late teens and 20 s—when PMDD/PMS is likely to develop. We presented a fictitious clinical case of a 23-year-old female and investigated whether the participants considered PMDD/PMS as a potential diagnosis. We also investigated the practitioners' basic understanding of PMDD/PMS. We analyzed survey responses from 26 psychiatrists and 140 clinical psychologists. Comparatively few respondents considered PMDD/PMS a possible diagnosis or routinely inquired about a patient's menstruation. When practitioners were provided with information linking observed symptoms to the menstrual cycle, most considered PMDD and PMS possible diagnoses. Recognizing and considering PMDD/PMS was related to the respondents' attributes. Clinicians should consider PMDD/PMS when treating women with depressive symptoms. • Comparatively few surveyed psychiatrists and clinical psychologists considered PMDD/PMS. • Comparatively few surveyed psychiatrists and clinical psychologists asked about menstruation. • Clinicians were more likely to consider PMDD/PMS when relevant information was provided. [ABSTRACT FROM AUTHOR]

• This study compared the efficacy of individualised homeopathic treatment with placebo in the symptoms of premenstrual syndrome. • Individually prescribed homeopathic medicines performed significantly better that placebo over 3 months of treatment. • Most frequently indicated/prescribed medicine was natrum muriaticum. Background: Premenstrual syndrome (PMS) is a common disorder among female population that adversely affects their physical and emotional well-being. Conventional treatments for PMS may have limitations and side effects, prompting a need for complementary therapeutic approaches. This double-blind, randomized, placebo-controlled trial aimed to investigate the efficacy of individualized Homeopathic medicines (IH) in treating PMS symptoms in comparison to placebo (PL). This study recruited female participants of reproductive age who had been experiencing premenstrual syndrome (PMS) for >3 months, from the Outpatient Department. The participants were randomly assigned to receive either IH or PL. The measured outcomes included the Shortened Premenstrual Assessment Form (SPAF) questionnaire as the primary outcome, and the Premenstrual Tension Syndrome Visual Analogue Scale (PMTS-VAS) and the Premenstrual Tension Syndrome Observer Rating Scale – Revised (PMTS-OR) as secondary outcomes. These measures were assessed at baseline and every month for 3 months. The results showed a statistically significant reduction in total SPAF scores for the IH group compared to the placebo group (F = 11.340; P < 0.001) at month 2 (-5.5 ± 1.8, P = 0.003), and month 3 (-6.6 ± 2.0, P = 0.002). Additionally, there were significant reductions in PMTS-VAS and PMTS-OR scores in the IH compared to placebo group. Natrum muriaticum (n = 4/30, 13.3 %) was the most frequently indicated medicines in the study. Four adverse events (13.33 %) occurred in the IH group, and six adverse events (16.67 %) in the Placebo group, with no serious events reported, and no additional medicinal treatment was required for participants during the study period. Individualized Homeopathic medicines were found to be significantly effective, compared to placebo in reducing PMS symptoms. Further independent replication is warranted to validate and corroborate these findings, as well as to identify the most effective Homeopathic medicines for treating PMS symptoms. Until then, clinicians may consider these findings when exploring personalized and holistic therapeutic strategies for managing PMS. CTRI/2020/11/028,796, dt. 02/11/2020 [ABSTRACT FROM AUTHOR]

Most persons with an active menstrual cycle suffer from a range of aversive symptoms (e.g. reduced ability to concentrate) in the days before their menstruation – the premenstrual syndrome (PMS). Biological and cognitive mechanisms of PMS are poorly understood. It has been shown that vagally mediated heart rate variability (vmHRV), a physiological marker of self-regulation, decreases during the PMS-affected cycle phase (luteal phase) only in individuals with high PMS symptomology. This study investigates the specific associations between vmHRV, PMS symptomology and cognitive self-regulation (attentional control). In this between-subject study, participants completed an vmHRV baseline measurement through electrocardiography, a reaction time paradigm to measure attentional control (modified attention network test revised, ANT-R) and filled out a questionnaire regarding impact of PMS as well as current menstrual phase. Mixed Model analysis showed interactions effects in the hypothesized direction. VmHRV was decreased during the luteal phase only in individuals with higher PMS. Analogously, performance in the Executive Functioning of the ANT-R task was reduced in the luteal compared to the follicular phase only in individuals with increased PMS symptoms. No effects were found in the Orienting Network Score. The results point in the direction of associations between vmHRV, PMS and self-regulation. This could hint at common underlying mechanisms. Further research, however, must be conducted to examine causal pathways to confirm these associations. [Display omitted] • Menstrual cycle fluctuations in attentional control and HRV depend on PMS severity. • Lower HRV during luteal phase only among high PMS individuals. • Lower attentional control during luteal phase only among high PMS individuals. [ABSTRACT FROM AUTHOR]

Since the inclusion of Premenstrual Dysphoric Disorder (PMDD) as a mood disorder in the DSM-5, Premenstrual Syndrome (PMS) symptoms have received more attention from researchers and clinicians. In this large-scale study, we investigated core psychological concepts relevant to mood disorder vulnerability between people with 1) no to mild, 2) moderate to severe, and 3) PMDD levels of PMS symptoms. Several trait measures related to mood disorders including depressive symptoms, feelings of stress and anxiety, and ruminative thinking were measured (single measurement, N = 380) along with state (momentary) reports of stress and stress-related perseverative thinking (measured twice, once in the follicular and once in the premenstrual/luteal phase, N = 237). We consistently observed that participants with higher severity of PMS symptoms also scored higher on depression, anxiety, stress, and rumination (trait measures). We also found consistent increases in momentary stress and stress-related perseverative ruminative thinking with increased PMS symptoms at each of our two test moments (in the middle of the follicular and premenstrual/luteal phase respectively). Interestingly, we did not find significant differences between our two test moments for any group, despite PMS being characterized by specific systems in the premenstrual/luteal phase. However, this could be due to noise surrounding the testing moments due to the temporal resolution of the questionnaires and the menstrual cycle estimation method. Nevertheless, these results suggest that stress and rumination are important psychological mechanisms to consider in PMS. Future PMS research studying stress and rumination on a day-to-day basis in combination with hormonal measures is warranted. [ABSTRACT FROM AUTHOR]

• Grey matter volumes do not change during SPRM treatment. • Cortical architecture does not change during SPRM treatment. • Grey matter structure changes do not relate to symptom severity change. Premenstrual dysphoric disorder (PMDD) is characterized by severe cyclic mood symptoms emerging in the luteal phase of the menstrual cycle. The variation in progesterone levels and its metabolites during the luteal phase seems critical to the occurrence of PMDD symptoms. Notably, the efficacy of selective progesterone receptor modulator (SPRM) treatment on the mental symptoms of PMDD has been recently demonstrated. In the present study, structural magnetic resonance imaging was used to assess the effects of SPRM treatment, compared with placebo, on grey matter morphology in women with PMDD. In total, 35 women were scanned during the luteal phase, before and after three months of treatment with SPRM or placebo. Symptom severity was assessed using the Daily Record of Severity of Problems (DRSP), while gonadal hormone levels were measured by liquid chromatography-tandem mass spectrometry. Region-of-interest and whole-brain approaches were employed to perform voxel-based morphometry analyses, subcortical volumetric analyses, and surface-based morphometry analyses. No interaction or main effects of treatment and time were observed on grey matter volume and cortical surface measures (cortical thickness, gyrification index, sulcal depth, and fractal dimension). The relationship between change in brain morphology and symptom severity was also explored but no treatment-dependant grey matter structure change was related to symptom severity change. These findings suggest that SPRM treatment does not impart macrostructural changes onto grey matter structure, at least in the short term. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome is associated with altered spontaneous brain activity in the late luteal phase, but the fluctuation patterns of brain activity throughout the menstrual cycle have not been revealed. Furthermore, it is also unknown whether the altered spontaneous brain activity during the whole menstrual cycle is further associated with their habitual use of maladaptive emotion regulation strategies. Based on the two reasons, electroencephalogram data and cognitive emotion regulation questionnaire from 32 women with high premenstrual symptoms (HPMS) and 33 women with low premenstrual symptoms (LPMS) were measured in the late luteal and follicular phases. Delta power, theta power, beta power, and the slow/fast wave ratios (SW/FW, including theta/beta power ratio [TBR] and delta/beta power ratio [DBR]) were calculated using both fixed frequency bands and individually adjusted frequency bands (based on the individual alpha peak frequency). The results showed that for the frontal and central DBR, as assessed both with fixed and individualized frequency bands, there was no difference between the two phases of the LPMS group, whereas there was a difference between the two phases of the HPMS group with a higher DBR in the late luteal phase than in the follicular phase. Further correlation results revealed that for women with HPMS in the late luteal phase, the frontal and central DBR values, as assessed both with fixed and individualized frequency bands, were positively correlated with self-blame and rumination. Consequently, HPMS was characterized by a fluctuation across the menstrual cycle in the DBR, which was further associated with maladaptive emotion regulation. • The relationship between PMS and SW/FW across the menstrual cycle was explored. • The SW/FW includes theta/beta power ratio (TBR) and delta/beta power ratio (DBR). • The HPMS group had a higher DBR in the late luteal than in the follicular phase. • There was no difference for the DBR between the two phases for the LPMS group. • The DBR was correlated with self-blame and rumination for the HPMS group. [ABSTRACT FROM AUTHOR]

Introduction: Premenstrual syndrome (PMS) and primary dysmenorrhea (PD) are common gynecological complications and there is evidence that inflammation may be an important factor in their etiology. There is a relationship between PMS and PD with susceptibility to allergic disorders. We aimed to assess the effect of curcumin co-administered with piperine on serum IL-10, IL-12 and IgE levels in patients with PD and PMS.Materials and Methods: A sample of 80 patients were recruited to this triple-blind, placebo-controlled clinical trial. Participants were randomly allocated to curcumin (n = 40) and control groups (n = 40). Each participant received one capsule (500 mg of curcuminoid plus piperine, or placebo) daily, from 7 days before until 3 days after menstruation for three consecutive menstrual cycles.Results: Serum IgE, IL-10 and IL-12 levels were quantified by using an ELISA kit. No significant differences were found between the two groups at baseline, including: age, BMI, and dietary intakes (P > 0.05). Curcumin + piperine treatment was associated with a significant reduction in the mean serum levels of IgE [from 223.6 ± 258.7 IU/mL to 161.3 ± 240.7; P = 0.001]; but there were no significant changes in the placebo group (P = 0.12). Serum concentrations of IL-10 and IL-12 before and after the trial period did not differ significantly between the two groups (P > 0.05).Conclusion: Curcumin plus piperine might be have positive effect on serum IgE levels with no significant changes on serum IL-10 and IL-12 in healthy young women with PMS and PD. Studies with higher doses and longer durations of treatment with curcumin are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Menstrual psychosis is a rare disorder characterized by acute onset of psychotic symptoms of brief duration associated with the hormonal fluctuations of the menstrual cycle. The onset of menstrual psychosis has been described at various stages of the reproductive life. To our knowledge, no cases of primary ovarian insufficiency (POI) on hormone replacement therapy (HRT) and menstrual psychosis have been described. 17-year-old patient with a past medical history significant for POI and premenstrual dysphoric disorder (PMDD) followed by Pediatric Gynecology. The patient was initially started on transdermal estrogen for POI with a good response, and subsequently, cyclic progesterone was added to provoke endometrial shedding. After initiating progesterone therapy, she experienced unexplained psychosis (disorganized, illogical thoughts, anxiety, insomnia, irritability, and auditory hallucinations). She was evaluated in the ED and as an outpatient by pediatric psychiatry. After evaluation due to the intermittent nature of the psychosis and its relation to the start of progesterone, Pediatric Psychiatry established menstrual psychosis as the likely diagnosis. Toxicology was also consulted and progesterone toxicity was ruled out. Genetic testing for progesterone metabolism was performed, but the results of her tests were inconclusive. EEG was normal. Pediatric Psychiatry started the patient on olanzapine 5 mg nightly. HRT was briefly stopped but the patient experienced hot flashes and difficulty sleeping. Due to the symptoms experienced and benefits of HRT, after shared decision-making, both parents and the patient agreed on starting continuous HRT with transdermal estrogen and oral daily progesterone. The patient is doing well and has not had repeat episodes of psychosis or mood symptoms on the current regimen. Limited literature exists regarding menstrual psychosis. Menstrual psychosis and PMDD have been associated with hormonal fluctuations. Continuous HRT might be a treatment option for POI patients who present with menstrual psychosis or PMDD that allows the continuation of hormonal support throughout life. A multidisciplinary approach might prove beneficial for these cases. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome (PMS) is a condition characterized by a combination of psychological and physical symptoms that begin during the luteal phase of the menstrual cycle, cease by the end of menstruation, with a symptom-free period till ovulation. A thorough history, along with other assessment tools, both in primary care and secondary care, is key in identifying and classifying the severity of the symptoms, which can range from mild to very severe. Symptoms can significantly affect a woman's quality of life and with up to 8% of women debilitated by severe PMS, it is vital that they are appropriately identified using investigations available and managed accordingly. Treatment can range from complementary therapies to hormonal and non-hormonal medication, to even surgery, and is introduced in a step-wise manner, often involving a multidisciplinary team. This review outlines the theories of the pathophysiology surrounding the condition, the classification of the disease, key investigations and management options advised in guidelines and research. [ABSTRACT FROM AUTHOR]

Background: Previous work implicates high pro-inflammatory biomarkers in mood disturbance and low brain-derived neurotrophic factor (BDNF) levels in major depression. However, in hormonally-sensitive premenstrual dysphoric disorder (PMDD), BDNF levels are higher when mood is worse. Perimenopausal depression has not been studied to date. We evaluated whether BDNF and inflammatory cytokines predict mood symptoms across the menstrual cycle in hormonally-sensitive perimenopausal depression symptoms.Methods: Data from 49 time points derived from mid-to-late follicular phase [M/L-FP] and peri‑menstrual assessments of 14 perimenopausal women ages 38-52 with ovulatory menstrual cycles 24-35 days long across 1-2 cycles for mood symptoms, BDNF levels, cytokines, gonadal steroids. Depression was assessed with Montgomery-Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI); irritability with Kellner Symptom Questionnaire Anger-Hostility subscale (SQ); overall psychological distress with Profile of Mood States (POMS). Mixed models were run on dependent measures of MADRS (primary endpoint) and other mood outcomes (BDI, POMS, SQ) with independent variables of interest (each biomarker, cycle phase), controlling for cycle number and participant.Results: After FDR adjustment, BDNF levels showed consistent significant positive relationships to MADRS (β=0.00053; p = 0.0028), POMS (β=0.00153; p = 0.0394), SQ (β=0.00053; p = 0.0067), and BDI (β=0.00039; p = 0.0231). Cycle phase did not affect this relationship. No other biomarker consistently predicted affective symptom severity.Limitations: Small sample size and large number of comparisons.Conclusion: In women with perimenopausal depression symptoms, BDNF is elevated in association with more severe mood symptomatology, resembling the pattern in hormonally-sensitive PMDD and suggesting a hormonally-sensitive mood disorder biomarker profile distinct from that of major depression. [ABSTRACT FROM AUTHOR]

Menstruation is a physiological event often associated with subjective distress. Is there a tool that assesses and objectively evaluates the global distress experienced by women during their period? An observational cross-sectional study conducted between June 2019 and May 2020 at Careggi University Hospital, Florence, Italy. A new questionnaire, The Menstrual Distress Questionnaire (MEDI-Q), was developed and administered to a group of healthy women (n = 418) of fertile age (18–50 years), without known uterine, psychiatric disorders, or both. The MEDI-Q investigated 25 items, covering the following areas: pain, discomfort, psychic or cognitive changes, gastrointestinal symptoms and changes in physiological functions. MEDI-Q Total Score and the three sub-scales, Menstrual Symptoms (MS), Menstrual Symptoms Distress (MSD) and Menstrual Specificity Index (MESI) were evaluated. The validation of MEDI-Q was achieved by testing test–retest reliability and internal consistency, convergent and concurrent validity. The MEDI-Q produced reliable results with good internal consistency, convergent and concurrent validity. MEDI-Q Total Score, MS and MSD all positively correlated with general psychopathology and premenstrual symptoms. A receiver operating characteristic analysis was used to determine the cut-off value of 20 (inclusive) and to identify the women with clinically relevant menstrual distress (area under the curve 0.90, 95% CI 0.86 to 0.93; P < 0.001). MEDI-Q is a new tool for evaluating menstruation-related distress, and provides a representative score of stress perception. MEDI-Q may be added to routine women's healthcare to help identify and adequately monitor menstruation-related disorders, and their effect on wellbeing, promptly. [ABSTRACT FROM AUTHOR]

Background: Whether premenstrual dysphoric disorder (PMDD) is correlated with the risk of suicidality and the extent of its effect on suicidality are unclear. The present study was conducted to elucidate the association between PMDD and suicidality from relevant studies.Methods: Four electronic databases, namely, Scopus, Embase, PubMed, and Web of Science, were searched from inception to November 15, 2020. Quality assessment, data synthesis, and sensitivity analysis were performed on the included studies.Results: Six studies with 8 532 participants were included in this meta-analysis. PMDD was associated with an increased risk of suicidal ideation (odds ratio [OR]=2.34, 95% confidence interval [CI]=1.50-3.18, I2=0.0%, p=0.99, k=4). Patients with PMDD had a greater risk of experiencing suicide attempt (OR=2.13, 95% CI=1.05-3.21, I2=0.0%, p=0.81, k=5). PMDD was associated with an increased risk of suicidal plan (OR=2.24, 95% CI=1.03-3.45, I2=0.0%, p=0.96, k=2).Limitations: The diagnosis of PMDD should be considered "provisional" in all the included studies.Conclusions: Among PMDD sufferers there would be a group of particularly suicidal women. Clinicians who treat patients with PMDD should be vigilant for signs of suicidal ideation and behavior to implement better treatment and preventive measures. [ABSTRACT FROM AUTHOR]

Background: Depression is the leading cause of disease burden among women worldwide. However, an understanding of symptom profiles among women at risk of mood disorders is limited. We determined distinct profiles of affective symptoms among high risk women, along with their distinguishing characteristics.Methods: Women were recruited from 17 clinical sites affiliated with the National Network of Depression Centers. They completed measures of depression (Patient Health Questionnaire - 9) and anxiety (Generalized Anxiety Disorder - 7) as well as questions regarding demographics, reproductive status, behavioral/mental health history, and life stress/adversity. Latent class analysis and multinomial logistic regression were used to identify and characterize symptom profiles.Results: 5792 women participated, ages 18 to 90 (M = 38). Three latent classes were identified: generally asymptomatic (48%), elevated symptoms of comorbid anxiety and depression (16%), and somatic symptoms (36%). Financial security and greater social support were protective factors that distinguished asymptomatic women. The profile of the class with elevated anxiety/depressive symptoms constituted a complex mix of adverse social determinants and potentially heritable clinical features, including a diagnosis of Bipolar Disorder. Women in the 3rd latent class were characterized by menstrual irregularity and a stronger expression of neurovegetative symptoms, especially sleep disturbance and fatigue.Limitations: Limitations included less than optimal racial diversity of our sample and reliance on self-report.Conclusions: Different symptom profiles may reflect distinct subtypes of women at risk of mood disorders. Understanding the etiology and mechanisms underlying clinical and psychosocial features of these profiles can inform more precisely targeted interventions to address women's diverse needs. [ABSTRACT FROM AUTHOR]

Objective: Combined oral contraceptives are often considered a treatment option for women with premenstrual syndrome or premenstrual dysphoric disorder also seeking contraception, but evidence for this treatment is scarce. We aimed to determine (1) the level of evidence for the efficacy of combined oral contraceptives in managing premenstrual depressive symptoms and overall premenstrual symptomatology and (2) the comparative efficacy of combined oral contraceptives (the International Prospective Register of Systematic Reviews registration number CRD42020205510).Data Sources: We searched Cochrane Central Register of Controlled Trials, PubMed, Web of Science, PsycINFO, EMCare, and Embase from inception to June 3, 2021.Study Eligibility Criteria: All randomized clinical trials that evaluated the efficacy of combined oral contraceptives in women with premenstrual syndrome or premenstrual dysphoric disorder were considered eligible for inclusion in this meta-analysis.Study Appraisal and Synthesis Methods: A random effect Bayesian pairwise and network meta-analysis was conducted with change in premenstrual depressive symptoms and overall premenstrual symptomatology between baseline and 3 cycles as outcome. Certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.Results: Of 3664 records, 9 eligible trials were included that studied 1205 women with premenstrual syndrome or premenstrual dysphoric disorder (mean age per study range, 24.6-36.5 years). The pairwise meta-analysis revealed that combined oral contraceptives were more efficacious than placebo in treating overall premenstrual symptomatology (standardized mean difference, 0.41; 95% credible interval, 0.17-0.67), but not premenstrual depressive symptoms specifically (standardized mean difference, 0.22; 95% credible interval, -0.06 to 0.47). However, none of the combined oral contraceptives were more effective than each other in reducing premenstrual depressive symptoms and overall premenstrual symptomatology.Conclusion: Combined oral contraceptives may improve overall premenstrual symptomatology in women with premenstrual syndrome or premenstrual dysphoric disorder, but not premenstrual depressive symptoms. There is no evidence for one combined oral contraceptive being more efficacious than any other. [ABSTRACT FROM AUTHOR]

This study was aimed at investigating the relationship between premenstrual syndrome (PMS), and childhood trauma and mental state in adolescents with PMS. This descriptive study was conducted with 702 students between September 2020 and November 2020. An Information Form, the PMS Scale, the Childhood Trauma Questionnaire (CTQ) and Symptom Checklist (SCL)-90 were used as the data collection tools. The mean scores the participants with PMS obtained from the Symptom Checklist (SCL)-90 and Childhood Trauma Questionnaire (CTQ) were higher than were those obtained by the participants without PMS. The Pearson correlation analysis revealed a positive and weak statistically significant relationship between the PMS Scale, and SCL-90 and CTQ. The results of the study demonstrated that adolescents with PMS suffered from childhood traumas and mental problems more. • Premenstrual syndrome is a very common health problem whose prevalence ranges between 20% and 90% in women of reproductive age worldwide • PMS is seen in women of all ages after menarche; however, studies report that it is most common in women aged between 18 and 20 years old. • Behavioral and psychological changes associated with PMS can cause problems on mental health depending on the individual's tolerance. • Exposure to traumatic experiences during childhood can impair women's ability to adapt to premenstrual physical and emotional changes. • There is only a limited number of studies in the literature evaluating PMS in young women in this context. [ABSTRACT FROM AUTHOR]

Background: Premenstrual syndrome (PMS) and depression co-occur frequently; however, their relationship remains controversial. This study was conducted primarily to discern heterogeneous patterns of such co-occurring symptoms in Chinese female university students, using a latent profile analysis (LPA), a person-centered statistical approach.Methods: The PMS Scale and Beck Depression Inventory were used to examine self-reported PMS and depression symptoms in 701 Chinese female university students. LPA, multinomial logistical regression, and analyses of variance were adopted to investigate latent profiles and their validity.Results: The LPA results indicated that a four-class solution characterized by low symptoms (57.2%), predominantly PMS (11.3%), predominantly depression (23.7%), and combined PMS-depression (7.8%) patterns fitted the data best. Age, first menstrual experience, and personality factors were associated with differences in nonparallel profiles characteristic of menstrual attitude.Limitations: Use of self-report measures can lead to response biases; the cross-sectional design at a single time point limits the examination of changes in symptom characteristics and members within the category over time; and the specific age group limits the generalizability of results.Conclusion: These results confirm that PMS is independent from depression, rather than a variant of depression, and can be used to resolve the controversy regarding the relationship between PMS and depression. The current findings highlight the need for identifying women at high risk for PMS and depression, and promoting interventions individually tailored to their symptom presentations. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric symptoms (PMDS) commonly co-occurred with mood disorders and correlated with suicide experiences in women. This study aims to examine the associations between PMDS and lifetime suicide experiences in patients with mood disorders. Participants were recruited from outpatient settings of two medical centers and one psychiatric hospital in Taiwan. Women aged 18–65 in non-acute state of major depressive disorder or bipolar affective disorder were recruited. PMDS and lifetime suicide experiences were defined by the Schedule for Affective Disorder and Schizophrenia-Lifetime. Lifetime suicide experiences were defined as no suicide experience, suicide plans only and suicide attempts. A total of 383 women participated in this study (54.8% of them were diagnosed with major depressive disorder), and 13.8% were diagnosed with PMDS. The prevalence of patients with lifetime suicide plans only and lifetime suicide attempts were 15.9% and 39.7%, respectively. In the univariate analysis, PMDS was correlated with lifetime suicide experience. After controlling for covariates, PMDS was a risk indicator for lifetime suicide attempts (OR: 3.46, 95% CI: 1.43–8.38) but not for suicide plans only (OR: 0.93, 95% CI: 0.28–3.11). PMDS correlated with lifetime suicide experiences in women with non-acute mood disorders. In particular, PMDS exhibited as an independent correlate for lifetime suicide attempts. [ABSTRACT FROM AUTHOR]

Atrophied lesion volume (aLV), a proposed biomarker of disability progression in multiple sclerosis (MS) and transition into progressive MS (PMS), depicts chronic periventricular white matter (WM) pathology. Meningeal infiltrates, imaged as leptomeningeal contrast enhancement (LMCE), are linked with greater cortical pathology. To determine the relationship between serum-derived proteomic data with the development of aLV and LMCE in a heterogeneous group of people with MS (pwMS). Proteomic and MRI data for 202 pwMS (148 clinically isolated syndrome /relapsing-remitting MS and 54 progressive MS (PMS)) were acquired at baseline and at 5.4-year follow-up. The concentrations of 21 proteins related to multiple MS pathophysiology pathways were derived using a custom-developed Proximity Extension Assay on the Olink™ platform. The accrual of aLV was determined as the volume of baseline T2-weighted lesions that were replaced by cerebrospinal fluid over the follow-up. Regression models and age-adjusted analysis of covariance (ANCOVA) were used. Older age (standardized beta = 0.176, p = 0.022), higher glial fibrillary acidic protein (standardized beta = 0.312, p = 0.001), and lower myelin oligodendrocyte glycoprotein levels (standardized beta = −0.271, p = 0.002) were associated with accrual of aLV over follow-up. This relationship was driven by the pwPMS population. The presence of LMCE at the follow-up visit was not predicted by any baseline proteomic biomarker nor cross-sectionally associated with any protein concentration. Proteomic markers of glial activation are associated with chronic lesional WM pathology (measured as aLV) and may be specific to the progressive MS phenotype. LMCE presence in MS does not appear to relate to proteomic measures. • Serum proteomic levels and MRI measures of atrophied lesion volume and leptomeningeal contrast enhancement was studied in 202 people with multiple sclerosis (pwMS). • Both higher glial fibrillary acidic protein and lower myelin oligodendrocyte glycoprotein levels were associated with accrual of aLV over 5-year follow-up. • The presence of LMCE was not predicted by any proteomic biomarker. [ABSTRACT FROM AUTHOR]

The article highlights upcoming potential treatments, which target different phases of inflammation and offer remyelinating strategies as well as direct and indirect neuroprotective and oligodendrocyte protective effects, providing a hopeful outlook for patients with primary and secondary progressive multiple sclerosis (PPMS and SPMS). The review aims to identify potential treatments and ongoing clinical trials for PPMS and SPMS, and compare their mechanisms of action, efficacy, and side effects with current treatments. We reviewed ongoing clinical trials for PPMS and SPMS on the NIH website, as well as articles from PubMed, Embase, and clinicaltrails.gov since 2010. BTKIs like, tolebrutinib, and fenebrutinib are being explored as potential PMS treatments. Vidofludimus calcium, an orally available treatment, has shown a reduction of active and new MRI lesions. Other treatments like simvastatin, N -acetylcysteine (NAC), and alpha-lipoic acid are being explored for their antioxidant properties. AHSCT and mesenchymal stem cell therapy are experimental options for younger patients with high inflammatory activity. SPMS and PPMS are being studied for new treatments and future trials should consider combination therapies targeting inflammation, demyelination, and neuronal death, as the pathogenesis of PMS involves complex factors. • Currently 15 clinical trials investigating different drugs for progressive multiple sclerosis. • Ocrelizumab, masitinib and ibudilast show promise in the management of PPMS. • Lamotrigine and Opcinumab did not show any efficacy. • More research is need for effective and safe treatment options for PPMS. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) is a mood disorder for which selective progesterone receptor modulator (SPRM) treatment has been demonstrated to be beneficial. The neural signatures of this treatment have been so far identified as greater fronto-cingulate reactivity during aggressive response to provocation, but no changes in terms of gray matter structure. White matter has recently been found to differ between patients with PMDD and healthy controls. The present study thus sought to investigate the relationship between white matter volume and SPRM treatment in patients with PMDD. A pharmaco-neuroimaging study was conducted on patients with PMDD participating in a randomized controlled trial. Participants underwent magnetic resonance imaging before and after treatment randomization to ulipristal acetate (an SPRM), or placebo, for three months. The interaction effect of treatment by time on white matter volume (WMV) was assessed. Voxel based morphometry analyses were performed on both a whole brain exploratory level and on regions of interest. No treatment effect was observed on WMV in any region, including the anterior thalamic radiations, cingulum, forceps minor, fornix, inferior fronto-occipital fasciculus, superior cerebellar peduncle, superior longitudinal fasciculus, and uncinate fasciculus. This is the first finding to indicate that no white matter volume alterations follow three-month progesterone antagonism, suggesting that white matter volume does not participate in symptom relief upon SPRM treatment for PMDD. • No effect of three-month treatment with SPRM on WMV. • No significant time by treatment interaction effect on WMV. • No follow-up differences on WMV between treatment groups. [ABSTRACT FROM AUTHOR]

[Display omitted] • Caffeine intake does not alter working memory and general attention. • The placebo effect can influence the caffeine response due to the expectation. • Long-term exposure to caffeine may have an influence on the results. • Caffeine's influence may be greater in activities involving attention and movement. This study aimed to evaluate the effect of caffeine on cognitive parameters in premenstrual syndrome women of childbearing age undergoing caffeine withdrawal, observing the influence of cytochrome P450 enzyme isozyme 1A2 genotypes. This is a crossover study with 26 women (all participants) grouped according to genotype (17 AA and 9 AC/CC). The cognitive assessment was carried out before and after caffeine or placebo. A significant increase in attention was showed both after placebo and caffeine administration, however, no statistical difference was observed between caffeine and placebo groups. This occurred both for all participants and in the genotype groups. Working memory was improved for all participants, and in the AC/CC group after placebo ingestion; the same did not occur after caffeine intake. In the AA group, no significant changes were observed for placebo or caffeine. Caffeine does not promote effects on cognitive performance in premenstrual syndrome women after caffeine abstinence. [ABSTRACT FROM AUTHOR]

[Display omitted] • HDACi post onset-treatment does not delay disease evolution during progressive EAE. • This occurs in spite of evidence of suppression of autoreactive lymphocytes. • Progression of EAE becomes independent from autoimmunity at symptom onset. • PMS therapy with HDACi needs to be reevaluated. Drugs able to efficiently counteract progression of multiple sclerosis (MS) are still an unmet need. Several lines of evidence indicate that histone deacetylase inhibitors (HDACi) are clinically-available epigenetic drugs that might be repurposed for immunosuppression in MS therapy. Here, we studied the effects of HDACi on disease evolution in myelin oligodendrocyte glycoprotein (MOG)-immunized NOD mice, an experimental model of progressive experimental autoimmune encephalomyelitis (PEAE). To obtain data of potential clinical relevance, the HDACi panobinostat, givinostat and entinostat were administered orally adopting a daily treatment protocol after disease onset. We report that the 3 drugs efficiently reduced in vitro lymphocyte proliferation in a dose-dependent manner. Notably, however, none of the drugs delayed evolution of PEAE or reduced lethality in NOD mice. In striking contrast with this, however, the lymphocyte proliferation response to MOG as well as Th1 and Th17 spinal cord infiltrates were significantly lower in animals exposed to the HDACi compared to those receiving vehicle. When put into a clinical context, for the first time data cast doubt on the relevance of HDACi to treatment of progressive MS (PMS). Also, our findings further indicate that, akin to PMS, neuropathogensis of PEAE in NOD mice becomes independent from autoimmunity, thereby corroborating the relevance of this model to experimental PMS research. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) is the most severe form for premenstrual distress. This study's objective was to understand the association among PMDD, premenstrual syndrome (PMS), and eating behaviors. Cross-sectional design. The survey was composed of validated measures. Female students at a nursing school. PMDD and PMS diagnoses were made using the Premenstrual Symptoms Screening Tool (PSST). Eating behaviors were assessed using the Eating Attitudes Test (EAT-26) and the Three-Factor Eating Questionnaire−Revised 18 (TFEQ-R18). Of the 504 participants, according to the PSST, 80 (15.9%) met the criteria for PMDD, 222 (44%) had moderate-to-severe PMS, and the remaining 202 (40%) participants showed mild or no premenstrual symptoms. The total EAT-26 scores were significantly higher in the PMDD group than in the other groups (P <.001). According to the cut-off value (20 points) of EAT-26, the total prevalence of disordered eating behaviors was also significantly higher in the PMDD group (45.5%) compared with the moderate-to-severe PMS group (16.5%) and the no/mild PMS group (13.6%) (P <.001). According to the TFEQ-R18 scores, significantly higher scores for emotional eating and uncontrolled eating were found in the PMDD group than in the other groups (P <.001 for each). Given that PMDD is defined as a more severe form of PMS with more strict criteria, the findings in this study reflect that as the severity of premenstrual symptoms increase, disordered eating behaviors also increase. To the best of our knowledge, this is the first study to compare eating behaviors among PMDD, moderate-to-severe PMS, and no/mild PMS groups. [ABSTRACT FROM AUTHOR]

This is the first study to assess the prevalence of symptoms of premenstrual dysphoric disorder (PMDD), episodes of postpartum depression symptoms (PPD) after first childbirth, and climacteric mood symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD). 209 consecutive women (18–71 years) with ADHD completed the PMDD chapter of the Neuropsychiatric Interview Plus version 5.0.0 to assess PMDD, the Edinburgh Postnatal Depression Scale to assess PPD, and the Greene Climacteric Scale to assess climacteric symptoms. Comorbid psychiatric disorders, medication use, and chronobiological sleep characteristics were also assessed. The prevalence of PMDD and PPD were high in ADHD, compared to the general population. PMDD symptoms were associated with less use of contraceptives. Antidepressants were associated with more PMDD symptoms. The following GCS scores were significant increased: anxiety, depression, and sexual dysfunction, vasomotor and somatic complaints. No significant differences were found in sleep characteristics or current comorbidity between the groups with and without PPD or PMDD, or increased climacteric scores. The prevalences of PMDD, PPD and climacteric scores were high in women with ADHD. This is the first study in women with ADHD that suggests that female ADHD patients suffer from significant PMDD symptoms, experience PPD during the first child birth, and experience more severe climacteric symptoms. [ABSTRACT FROM AUTHOR]

Background: Internet addiction(IA) is now very common. However, few studies have explored the sex differences in risk factors for IA, especially among Chinese college students. This study aimed to investigate the sex differences in prevalence, risk factors and clinical correlates of IA among Chinese college students.Methods: A total of 8098 college students from Hunan province were recruited using a cross-sectional design and a convenience sampling method. Each student filled out the survey online anonymously, which collected their information on their socio-demographics, internet addiction(Revised Chinese internet addiction scale;CIAS-R), ADHD(Wender Utah Rating Scale and World Health Organization (WHO) Adult ADHD Self-Report Scale v 1.1 Symptom Checklist), depression(Self-reporting Depression Scale;SDS), insomnia(Athens Insomnia Scale;AIS), anxiety(Self-Rating Anxiety Scale;SAS) and suicidal behaviors through WeChat.Results: Overall, the prevalence of IA in males and females was 7.21%(259/3592) and 8.17%(368/4506), respectively. Multivariate logistic regression analysis revealed that suicidal ideation[odds ratio (OR),1.557;95% confidence interval (CI),1.083-2.240], suicide attempts(OR,2.081;95%CI:1.271-3.409), ADHD(OR,6.487;95%CI,4.697-8.959) and insomnia(OR,2.596;95%CI,1.910-3.529) were independent risk factors for male IA after controlling for confounding variables. Nationality(OR,1.507;95%CI,1.058-2.145), suicidal ideation(OR,2.012;95%CI,1.532-2.641), depression(OR,1.771;95%CI:1.071-2.930), ADHD(OR,4.497; 95%CI,3.285-6.158) and insomnia(OR,2.356;95%CI,1.813-3.061) were independent risk factors for female IA.Limitation: No causal relationships could be drawn due to the cross-sectional design.Conclusions: This study shows IA is common among both sexes. IA is significantly associated with ADHD, insomnia and suicidal behaviors in both male and female students, indicating the importance of screening IA and addressing ADHD, insomnia and suicidal behaviors to improve the mental health of college students and better prevent suicide in both sexes. [ABSTRACT FROM AUTHOR]

Background: Previous literature suggests a positive association between history of premenstrual syndrome (PMS) and development of postpartum depression (PPD); however, limited evidence has come from prospective population-based studies and whether history of depression affects this association is unknown.Methods: This study included 5479 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health and estimated the association between pre-pregnancy PMS and PPD. Participants were followed from 22-27 years in 2000 to 37-42 years in 2015. PMS was collected from a 4-category Likert-scale reporting on frequency of PMS in the last 12 months (never, rarely, sometimes, or often) at the survey preceding an index birth. PPD was ascertained from reports of doctor diagnoses for each birth. Relative risks (RRs) and 95% confidence intervals (CIs) were used to estimate the association of interest. The role of history of depression was assessed by testing its interaction with pre-pregnancy PMS.Results: During 15 years' follow-up, 15.4% of participating women reported PPD; and 55.1% reported PMS (rarely: 17.2%, sometimes: 25.7%, and often: 12.2%). Compared to women who had no PMS before pregnancy, those who rarely had PMS had similar risk of PPD (1.03, 0.82-1.30); whereas those who sometimes or often had PMS had significantly higher risk of PPD (1.31, 1.09-1.57 and 1.51, 1.22-1.87, respectively). History of depression did not affect the association.Limitations: PMS was self-reported. PMS severity was not collected.Conclusions: This large population-based study provides evidence of a dose-response relationship between PMS prior to pregnancy and PPD, independent of history of depression. Evidence to date suggests PMS has the potential to help identify women at increased risk of PPD before pregnancy. [ABSTRACT FROM AUTHOR]

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether menstrual symptoms are associated with increased risk of hypertension among young women, and whether the relationship is bi-directional.Study Design: We included 7729 women participating in the Australian Longitudinal Study on Women's Health, aged 22-27 years in 2000 and who were followed up every 3 years until 2015. Premenstrual syndrome, painful (dysmenorrhoea), heavy (menorrhagia), and irregular menstrual periods over the previous 12 months were self-reported and recorded as 'never', 'rarely', 'sometimes', or 'often'. Questions regarding physician-diagnosed hypertension were asked, specifically for other than during pregnancy (defined as chronic hypertension) and during pregnancy (hypertensive disorder in pregnancy, HDP). Longitudinal data were analysed with generalised estimating equation time-lagged models to estimate relative risks (RRs) and 95 % confidence intervals (CI), adjusted for time-varying covariates.Mian Outcome Measures: Chronic hypertension, HDP, and menstrual disorders.Results: Over 15 years of follow-up, 757 women (9.8 %) reported having been diagnosed with chronic hypertension. Among 4473 parous women, 483 (10.8 %) reported a diagnosis of HDP. Women who often experienced heavy periods had an increased risk of incident chronic hypertension (RR 1.53, 1.13-2.09), compared with those who had not experienced heavy periods. We also found that women with chronic hypertension had an increased risk of incident heavy (RR 1.23, 1.02-1.50) and irregular periods (RR 1.42, 1.17-1.72). However, there was no apparent association between any menstrual symptoms and subsequent risk of HDP.Conclusions: The association between heavy periods (menorrhagia) and chronic hypertension may be bi-directional in young women. Chronic hypertension may also be associated with subsequent risk of irregular periods. [ABSTRACT FROM AUTHOR]

Introduction: Burn injuries are common afflictions; however, conservative wound care frequently leads to poor treatment compliance and physical disability in deep burn patients. Therefore, regenerative biologic materials, which are more effective for tissue repair, are required, particularly for deep second-degree burns. A novel spray formulation of basic fibroblast growth factors (bFGF) was produced by synthesizing fibroblast growth factor proteins. In this post-marketing surveillance (PMS) study, we assessed the safety and efficacy of bFGF and indirectly compared this formulation with cultured epidermal autografts (CEAs) for treating deep second-degree burns.Materials and Methods: A total of 3173 patients treated at 15 hospitals were used for PMS of bFGF in South Korea for six years. In total, 1630 patients with deep second-degree burns were selected for assessing adverse events (AEs) of bFGF treatments. Efficacy was evaluated according to time periods until re-epithelialization, and clinical usefulness of bFGF was indirectly compared with that of CEAs.Results: AEs occurred in 37 patients (2.3%) and included application site pain (1.7%) and contact dermatitis (0.6%). All AEs were mild and were evaluated as probably unrelated with bFGF. The average time for re-epithelialization was 8 days; this time span was significantly longer after major burns (9.7 days) than after minor (7.8 days) or moderate burns (7.9 days). Most treated burn wounds (99.8%) were assessed as improved. The indirect comparison included 534 patients using the same inclusion criteria for CEA patients (n = 35). The bFGF treatment demonstrated superior efficacy compared to CEAs by significantly reducing the average day to application (5.4 vs. 8.8 days) and re-epithelialization time (7.1 vs. 13.7 days).Conclusion: Our study demonstrated that bFGF is a compelling regenerative therapy with competitive clinical efficacy and safety for deep second-degree burns and reduced treatment time, which is expected to reduce medical costs, particularly for deep second-degree burn patients. [ABSTRACT FROM AUTHOR]

Background: A high rate of bullying episodes has been reported in Italian schools, as well as its association with psychopathology in adolescents. However, information regarding moderators of this interaction are still lacking. This study explored whether gender, exercise frequency, and sport participation exerted a protective effect on the association between bullying and depressive symptoms in Italian students.Methods: Researchers obtained data from 4,829 Italian youth ages 13 to 21 using the self-report Epidemiologia dell'Infortunistica Stradale survey (EDIT) developed by the Regional Health Agency of Tuscany, Italy. Three structural equation models were run to assess moderators of the association between bullying and depressive symptoms. Moderators examined in the models included gender, exercise frequency, and sport participation.Results: The association between bullying and depressive symptoms was stronger for females (B=0.95, SE=0.04, p< .001) than for males (B=0.45, SE=0.00, p< .001) and for students who did not play sports (B=0.74, SE=0.09, p< .001) than for those who played sports (B=0.61, SE=0.06, p< .001). Females may be more affected by the depressive effects of bullying than males.Conclusions: Participation in sports buffers against the effects of bullying and may prove a helpful strategy for increasing exercise, positive peer interactions, and mood in adolescents.Limitations: The cross-sectional nature of the study, the possible role of BMI as a confounding factor and the use of a not widely used measure of depression. [ABSTRACT FROM AUTHOR]