title: An exploratory dimensional approach to premenstrual manifestation of obsessive-compulsive disorder symptoms: a multicentre study.
abstract: OBJECTIVE
  In women with obsessive-compulsive disorder (OCD), symptom severity appears to fluctuate over the course of the menstrual cycle. The objective of this paper was to compare female OCD patients with and without premenstrual worsening of obsessive-compulsive symptoms (OCS), in terms of the clinical characteristics of OCD.
  
  
  METHODS
  This was a cross-sectional study involving 455 women with OCD, of whom 226 (49.7%) had experienced premenstrual OCS worsening and 229 (50.3%) had not (PMOCS-worse and PMOCS-same groups, respectively). Data were collected with the original and dimensional versions of the Yale-Brown obsessive-compulsive scale, as well as with the Beck Depression Inventory (BDI) and Beck anxiety inventory (BAI).
  
  
  RESULTS
  We found significant differences between the PMOCS-same and PMOCS-worse groups, the latter showing a higher frequency of suicidal ideation (P<.001), suicide attempts (P=.027), current use of selective serotonin reuptake inhibitors (P=.022), lifetime use of mood stabilisers (P=.015), and sexual/religious obsessions (P<.001; OR=1.90), as well as higher scores on the BDI (P<.001) and BAI (P<.001).
  
  
  CONCLUSIONS
  Underscoring the fact that OCD is a heterogeneous disorder, there appears to be a subgroup of female OCD patients in whom the premenstrual period is associated with a higher frequency of sexual/religious obsessions, depression, anxiety, and suicidality. This might be attributable to hormonal fluctuations. Further studies are warranted in order to investigate this hypothesis by evaluating such patients at different phases of the menstrual cycle, as well as measuring hormonal levels.
authors.affiliation: The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, São Paulo, Brazil.
authors.forename: Luciana
authors.initials: L
authors.lastname: Moreira
authors.forename: Helena
authors.initials: H
authors.lastname: Bins
authors.forename: Ricardo
authors.initials: R
authors.lastname: Toressan
authors.forename: Cláudia
authors.initials: C
authors.lastname: Ferro
authors.forename: Thiago
authors.initials: T
authors.lastname: Harttmann
authors.forename: Kátia
authors.initials: K
authors.lastname: Petribú
authors.forename: Mário Francisco
authors.initials: MF
authors.lastname: Juruena
authors.forename: Maria Conceição
authors.initials: MC
authors.lastname: do Rosário
authors.forename: Ygor Arzeno
authors.initials: YA
authors.lastname: Ferrão
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000150:complications / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D011293:Premenstrual Syndrome / Q000150:complications / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D013406:Suicide, Attempted
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors