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Predictors of premenstrual impairment among women undergoing prospective assessment for premenstrual dysphoric disorder: a cycle-level analysis

Published online by Cambridge University Press:  14 February 2017

K. M. Schmalenberger ,
T. A. Eisenlohr-Moul ,
P. Surana ,
D. R. Rubinow  and
S. S. Girdler
K. M. Schmalenberger
Affiliation:
Heidelberg University, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Heidelberg University, Heidelberg, Germany
T. A. Eisenlohr-Moul*
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
P. Surana
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
D. R. Rubinow
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
S. S. Girdler
Affiliation:
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
*
*Address for correspondence: T. A. Eisenlohr-Moul, PhD, University of North Carolina at Chapel Hill, 2218 Nelson Highway, Suite 3, Chapel Hill, NC 27517, USA. (Email: [email protected])
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Abstract

Background

Women who experience significant premenstrual symptoms differ in the extent to which these symptoms cause cyclical impairment. This study clarifies the type and number of symptoms that best predict premenstrual impairment in a sample of women undergoing prospective assessment for premenstrual dysphoric disorder (PMDD) in a research setting. Central research goals were to determine (1) which emotional, psychological, and physical symptoms of PMDD are uniquely associated with premenstrual impairment, and (2) how many cyclical symptoms optimally predict the presence of a clinically significant premenstrual elevation of impairment.

Method

A total of 267 naturally cycling women recruited for retrospective report of premenstrual emotional symptoms completed daily symptom reports using the Daily Record of Severity of Problems (DRSP) and occupational, recreational, and relational impairment for 1–4 menstrual cycles (N = 563 cycles).

Results

Multilevel regression revealed that emotional, psychological, and physical symptoms differ in their associations with impairment. The core emotional symptoms of PMDD were predictors of impairment, but not after accounting for secondary psychological symptoms, which were the most robust predictors. The optimal number of premenstrual symptoms for predicting clinically significant premenstrual impairment was four.

Conclusion

Results enhance our understanding of the type and number of premenstrual symptoms associated with premenstrual impairment among women being evaluated for PMDD in research contexts. Additional work is needed to determine whether cognitive symptoms should receive greater attention in the study of PMDD, and to revisit the usefulness of the five-symptom diagnostic threshold.

Keywords

Impairmentmenstrual cyclepremenstrual dysphoric disorderpremenstrual syndromewomen's health
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 9 , July 2017 , pp. 1585 - 1596
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

†

These authors served as joint first authors.

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