Fast Five Quiz: Are You Familiar With These Conditions Associated With Depression?

Stephen Soreff, MD


December 16, 2019

For the diagnosis of PMDD, what is key to recognize is that the symptoms must be discretely related to the menstrual cycle and must not merely represent an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, dysthymic disorder, or a personality disorder (although the symptoms may be superimposed on those of any of these disorders).

Because depression is a common symptom of PMDD, patients are at increased risk for suicide. A case/control study of fertile females with regular menstrual cycles who attempted suicide (with blood donors used as controls) showed that attempts during the luteal phase were no more frequent in females with PMDD than in those without PMDD. These findings suggest that PMDD may not be associated with suicidal acts during the luteal phase, when premenstrual symptoms are present. It is important to note that patients with PMDD may experience both a depression and its accompanying suicidal behavior throughout the menstrual cycle.

Randomized controlled trials have shown CBT to be effective in women with PMDD. One systematic review and meta-analysis by Busse and colleagues showed that CBT significantly reduces both anxiety and depression and suggested a possible beneficial effect on behavioral changes and interference of symptoms with daily living.

A randomized, double-blind, counterbalanced, crossover study of dim red light therapy versus bright white light therapy in women who met the criteria for late luteal phase dysphoric disorder showed that the bright light condition significantly reduced depression and premenstrual tension scores during the symptomatic luteal phase compared with baseline values, whereas the dim light condition did not.

For more on PMDD, read here.


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