title: Relationship of premenstrual syndrome and premenstrual dysphoric disorder with major depression: relevance to clinical practice.
abstract: BACKGROUND
  Premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) and depressive disorder are fairly common; symptoms do overlap, often under-identified and under-emphasized, particularly in rural India.
  
  
  OBJECTIVE
  The objective was to assess the occurrence of PMS and PMDD in a sample of students and staff of a nursing college and to find their correlation with depression.
  
  
  METHODS
  A prospective cohort study; Tertiary Care Hospital in Rural India (Wardha, Maharashtra); 118 female nursing students or staff aged between 18 and 40 years, who were likely to stay within the institution for the study period. The participants were rated on Penn daily symptom report prospectively for a period of 3-month. Those who scored positive were applied diagnostic and statistical manual of mental disorders, 4(th) edition, text revision (DSM-IV TR) criteria for PMDD; and were applied primary care evaluation of mental disorders depression screening followed by DSM-IV TR criteria for depression. Severity of depression was measured using Hamilton Depression Rating Scale.
  
  
  RESULTS
  Main outcome measures were frequency and severity of depression in individuals with PMS and PMDD and their clinical and sociodemographic correlation. The age range of the sample was 18-37 years. Some PMS symptoms were observed in 67%; diagnosis of PMDD in 10%; depressive symptoms in 28% of the sample. 46.4% of those with depressive symptoms had major depression. The diagnosis of major depression was significantly associated with the severity of PMS symptoms as well as the presence of PMDD.
  
  
  CONCLUSIONS
  Premenstrual syndrome is present in a substantial proportion of young females. Concurrent depression is increased by the severity of PMS symptoms and the presence of PMDD. Gynecologist needs to screen such subjects for depression and refer to mental-health professional early, in routine clinical practice.
authors.affiliation: Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Sector - 12, Chandigarh, India.
authors.forename: Susanta Kumar
authors.initials: SK
authors.lastname: Padhy
authors.affiliation: Department of Psychiatry, Jawaharlal Nehru Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Sidharth
authors.initials: S
authors.lastname: Sarkar
authors.affiliation: Department of Psychiatry, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India.
authors.forename: Prakash B
authors.initials: PB
authors.lastname: Beherre
authors.affiliation: Institute of Human Behavior and Allied Sciences, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Rathi
authors.affiliation: Department of Preventive and Social Medicine, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India.
authors.forename: Mahima
authors.initials: M
authors.lastname: Panigrahi
authors.affiliation: Department of Psychiatry, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra, India.
authors.forename: Pradeep Sriram
authors.initials: PS
authors.lastname: Patil
keywords: Depression; India; premenstrual dysphoric disorder; premenstrual syndrome