Premenstrual syndromes and affective disorders: is there a temperamental relationship?

ABSTRACT Background: The term “premenstrual syndrome” (PMS) is used to describe a variety of physical, cognitive, affective and behavioral symptoms that can occur cyclically in the luteal phase of the menstrual cycle and resolve rapidly in the follicular phase, a few days after the onset of menstruation. The most common affective symptoms are irritability, anxiety, tension, emotional lability, crying, anger, confusion, impaired memory skill, sleep disorders, social withdrawal. Scientific literature about Premenstrual Syndromes is well represented, whereas very few articles are written about its correlates with emotional dysregulation. The aim of this study was to evaluate the role of emotional dysregulation in the developing premenstrual Syndromes in a sample of patients with psychiatric diagnosis. Method: Sixty-seven women with psychiatric diagnosis were enrolled in this study and all patients were evaluated at T0, T1 and T2 with a set of questionnaires that included the State-Trait Anxiety Inventory (STAI) to evaluate anxiety symptoms, the RIPoST questionnaire to evaluate the emotional features. At T0 they were also evaluated with the structured interview for DSM-IV TR (SCID-I) to assess the presence of a current or lifetime psychiatric diagnosis, and were administered the Gynecological criteria of American College of Obstetricians and Gynecologist (ACOG) and the Daily Record of Severity of Problems (DRSP) to confirm a diagnosis of premenstrual syndrome and premenstrual dysphoric disorder, respectively. We compared two subgroups of patients: the first group with premenstrual syndromes (PMSs) and the second group without premenstrual syndromes (N-PMSs). Results: A multivariate linear regression analysis was run including having at least PMS as the dependent variable and the variables that were statistically significant to the univariate regression as the independent variables. The analysis revealed that the variables mostly associated with the premenstrual syndromes in order of statistical significance were STAI- total scale (p=0,022) and Emotional Reactivity RIPoST subscale (p=0,046); Conclusions: The multivariate analysis revealed that the variables mostly associated with the Premenstrual Syndromes in order of statistical significance were STAI- total scale and Emotional Reactivity RIPoST subscale; so we can assume that emotional dysregulation and high levels of anxiety (seen as trait) can be considered as a vulnerability factor for developing PMSs, independently from others diagnosis and from the others factors considered (age, coffee use, psychopharmacological therapy, emotional (in)stability, positive emotionality). To the best of our knowledge, this study is the first to report an association between emotional dysregulation and Premenstrual Syndromes in a sample of psychiatric patients. The current literature on this topic is still insufficient. For this reason, further studies are necessary to better define etiopathogenesis and treatment of PMSs