|
Depression and the Lifetime Reproductive Cycle |
|
|
Written by HealthyPlace.com Staff Writer
|
|
|
Dec 05, 2008 |
A + A - RESET
|
|
|
Page 1 of 6 Depression can appear throughout a women's lifetime, but research has shown that there are some distinct links between depression and a women's reproductive lifecycle.
Premenstrual Dysphoric Disorder
The DSM-IV classifies premenstrual dysphoric disorder (PMDD) under research diagnostic criteria as depression not otherwise specified (Table below). Mood and anxiety symptoms can occur only during the premenstrual period, or preexisting symptoms can become worse at this time. Identifying and treating symptoms that have a significant effect on patients is important; dismissing them as "simple" premenstrual symptoms deprives women of potentially beneficial treatment.
PMDD is a severely distressing and debilitating condition that requires treatment. Between 3 and 5 percent of women meet the diagnostic criteria for this disorder, which presents with symptoms of depression and anxiety as well as cognitive and physical symptoms. The diagnosis of PMDD requires the presence of five of 11 symptoms, with at least one of the first four symptoms experienced during the last week of the luteal phase; in addition, remission of symptoms must occur within a few days of the onset of menstruation. The symptoms should not represent the exacerbation of preexisting anxiety, depression or personality disorder. Furthermore, duration, impairment and prospective diagnostic validation criteria must be met.
Research Diagnostic Criteria for Premenstrual Dysphoric Disorder *
|
|
A. Presence of five of 11 depressive, anxiety, cognitive or physical symptoms, with at least one of four specific symptoms experienced in most of the menstrual cycles for the past year. The symptoms may begin a week before menses and must completely remit within a few days after the onset of menses.
|
| Depressive Symptoms |
Anxiety Symptoms |
Cognitive Symptoms |
Physical symptoms |
|
markedly depressed mood, feelings of hopelessness, self-deprecation†
|
Marked anxiety, tension, feeling of being "keyed up"or "on edge"†
|
Subjective sense of having difficulty concentrating
|
Breast tenderness or swelling, headaches, joint or muscle pain, weight gain, "bloated" feeling
|
|
Suddenly feeling sad or tearful, with increased sensitivity to personal rejection†
|
Persistent or marked irritability, anger, increased interpersonal conflicts†
|
|
|
|
Decreased interest in usual activities
|
Feeling overwhelmed or out of control
|
|
|
|
Lethargy, fatigue, marked lack of energy
|
|
|
|
|
Marked changes in appetite and cravings for certain foods
|
|
|
|
|
Insomnia or hypersomnia
|
|
|
|
|
B. Symptoms interfere with social, occupational, sexual or school functioning.
C. Symptoms are discretely related to menstrual cycle and are not merely worsening of preexisting depression, anxiety or personality disorder.
D. Criteria A, B and C must be confirmed prospectively by daily ratings for at least two consecutive menstrual cycles.
|
|
*--Classified as depression not otherwise specified.
† --Of these four symptoms, at least one must be present in most of a year's menstrual cycles.
Information from American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, D.C.: American Psychiatric Association, 1994:715-8. Copyright 1994.
|
|
|
Top
|
E-mail
|
|
|
Last Updated( Feb 27, 2009 )
|
reviewed by: Harry Croft, MD
Psychiatrist, HealthyPlace.com Medical Director
|
|
