精神障碍和治疗

Premenstrual Exacerbations of Mood Disorders

Abstract

Thereasa Cronan

Premenstrual exacerbations (PMEs) of persistent mood disorders are little understood, in contrast to premenstrual dysphoric disorder (PMDD). This review's objectives are to explore the clinical and research ramifications of PME in unipolar depression and bipolar disorder, as well as diagnostic difficulties, epidemiology, underlying mechanisms, and treatment. Around 60% of women with mood disorders, according to communitybased and clinical studies, report PME, and some bipolar disorder sufferers also experience symptom flare-ups around the ovulation. PME typically foresees a more serious illness course and an increased burden. The overlap of their underlying biological pathways is yet unknown, despite the fact that PME and PMDD both appear to be influenced by increased sensitivity to variations in sex hormone levels throughout the menstrual cycle. PME results for effective PMDD therapies are lessened or non-existent. Pharmacological therapies for PME in mood disorders mostly tend to benefit from customizable dosage augmentations during the luteal phase for the underlying disease. The available data, however, is scant and largely based on old, limited studies and case reports. To get accurate prevalence estimates, information on the clinical impact of PME of mood disorders, and to identify underlying processes, more systematic research using uniformly defined and prospectively assessed subgroups of PME in larger epidemiological and clinical samples is required. It is also necessary to conduct larger randomised controlled trials to find effective pharmacological and psychological therapies for affected women.