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Self-reported premenstrual exacerbation of depressive symptoms in patients seeking treatment for major depression

Published online by Cambridge University Press:  06 January 2005

S. G. KORNSTEIN ,
A. T. HARVEY ,
A. J. RUSH ,
S. R. WISNIEWSKI ,
M. H. TRIVEDI ,
D. S. SVIKIS ,
N. D. McKENZIE ,
C. BRYAN  and
R. HARLEY
S. G. KORNSTEIN
Affiliation:
Virginia Commonwealth University, Richmond, VA, USA
A. T. HARVEY
Affiliation:
Via Christi Research, Inc., Wichita, KS, USA
A. J. RUSH
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
S. R. WISNIEWSKI
Affiliation:
University of Pittsburgh, Pittsburgh, PA, USA
M. H. TRIVEDI
Affiliation:
University of Texas Southwestern Medical Center, Dallas, TX, USA
D. S. SVIKIS
Affiliation:
Virginia Commonwealth University, Richmond, VA, USA
N. D. McKENZIE
Affiliation:
Virginia Commonwealth University, Richmond, VA, USA
C. BRYAN
Affiliation:
University of Pittsburgh, Pittsburgh, PA, USA
R. HARLEY
Affiliation:
Massachusetts General Hospital, Boston, MA, USA
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Abstract

Background. Very little research has examined the frequency with which women with major depressive disorder experience premenstrual exacerbation (PME) of depression or the characteristics of those who report such worsening. The NIMH Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study provides a unique opportunity to evaluate PME in depressed women seeking treatment in primary care or psychiatric settings.

Method. This report presents data from the first 1500 participants enrolled in the STAR*D study. Premenopausal women with major depressive disorder were asked if they experienced a worsening of their depressive symptoms 5–10 days prior to menses. Those reporting PME were compared with those reporting no PME with regard to sociodemographic characteristics, course of illness features, symptom presentation, general medical co-morbidity, functional impairment, and quality of life.

Results. Of 433 premenopausal women not taking oral contraceptives, 64% reported a premenstrual worsening of their depression. Women who reported PME had a longer duration of their current major depressive episode [30·7 (S.D.=73·7) months versus 13·5 (S.D.=13·2) months; p=0·001], as well as greater general medical co-morbidity. Women reporting PME were also more likely to endorse symptoms of leaden paralysis, somatic complaints, gastrointestinal complaints, and psychomotor slowing, and were less likely to endorse blunted mood reactivity.

Conclusions. PME is endorsed by the majority of premenopausal women with major depressive disorder and appears to be associated with a longer duration of depressive episode. PME is a common and important clinical issue deserving of further attention in both research and practice.

Type
Research Article
Information
Psychological Medicine , Volume 35 , Issue 5 , May 2005 , pp. 683 - 692
Copyright
© 2005 Cambridge University Press

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