Symptoms of depression in late luteal phase dysphoric disorder: a variant of mood disorder?
BACKGROUND
In premenstrual syndrome, depressed mood in the luteal phase of the menstrual cycle is acknowledged, whereas the presence of symptoms of depression during the follicular phase remains in debate.


METHODS
On the basis of prospective daily recording of the presence and severity of symptoms for at least two menstrual cycles, 43 women were diagnosed with Late Luteal Phase Dysphoric Disorder (LLPD) according to the criteria of the third edition revision of the Diagnostic and Statistical Manual of Mental Disorders. They were compared to a group of 85 women who showed no evidence of LLPD for two menstrual cycles. Structured psychiatric interviews were administered during the follicular phase. Only those subjects without Axis I disorders were subsequently included in the study.


RESULTS
Those women with minor/moderate symptoms of depression had an odds of suffering from LLPD of 1.9 (95% CI=1.5-2.4, p<0.001) in relation to increasing severity of symptoms of depression at the total MADRS scale (1-point increase). The ORs of LLPD in relation to each dimension (1-point increase) of the emotional/affective, cognitive, and neurovegetative symptoms were 1.6 (95% CI=1.2-2.3, p=0.003), 2.8 (95% CI=0.9-8.5, p=0.077) and 3.3 (95% CI=1.9-5.9, p<0.001), respectively.


CONCLUSIONS
No hormonal changes that may be associated with symptoms of LLPD were determined in this study.


CONCLUSIONS
LLPD is likely to represent a variant of a depressive disorder, where premenstrual psychobiological changes seem to exacerbate mild depressive symptoms and signs to which LLPD women are otherwise predisposed. This hypothesis opens new perspectives for prevention and of even treatment for LLPD. Further longitudinal studies with larger populations and evaluation of hormonal changes are needed to confirm these data.
De Ronchi
Diana
D
Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy. deronchi@alma.unibo.it
Ujkaj
Manjola
M
Boaron
Federico
F
Muro
Ambra
A
Piselli
Massimiliano
M
Quartesan
Roberto
R
D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005498:Follicular Phase / Q000523:psychology; D006791:Hostility; D006801:Humans; D016015:Logistic Models; D008499:Medical Records; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011293:Premenstrual Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index