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https://observatorio.fm.usp.br/handle/OPI/24349
Title: | Increased illness burden in women with comorbid bipolar and premenstrual dysphoric disorder: data from 1 099 women from STEP-BD study |
Authors: | SLYEPCHENKO, A.; FREY, B. N.; LAFER, B.; NIERENBERG, A. A.; SACHS, G. S.; DIAS, R. S. |
Citation: | ACTA PSYCHIATRICA SCANDINAVICA, v.136, n.5, p.473-482, 2017 |
Abstract: | Background: The impact of comorbid premenstrual dysphoric disorder (PMDD) in women with bipolar disorder (BD) is largely unknown. Aims: We compared illness characteristics and female-specific mental health problems between women with BD with and without PMDD. Materials & Methods: A total of 1 099 women with BD who participated in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) were studied. Psychiatric diagnoses and illness characteristics were assessed using the Mini International Neuropsychiatric Interview. Female-specific mental health was assessed using a self-report questionnaire developed for STEP-BD. PMDD diagnosis was based on DSM-5 criteria. Results: Women with comorbid BD and PMDD had an earlier onset of bipolar illness (P < 0.001) and higher rates of rapid cycling (P = 0.039), and increased number of past-year hypo/manic (P = 0.003), and lifetime/past-year depressive episodes (P < 0.05). Comorbid PMDD was also associated with higher proportion of panic disorder, post-traumatic stress disorder, generalized anxiety disorder, bulimia nervosa, substance abuse, and adult attention deficit disorder (all P < 0.05). There was a closer gap between BD onset and age of menarche in women with comorbid PMDD (P = 0.003). Women with comorbid PMDD reported more severe mood symptoms during the perinatal period and while taking oral contraceptives (P < 0.001). Discussion: The results from this study is consistent with research suggesting that sensitivity to endogenous hormones may impact the onset and the clinical course of BD. Conclusions: The comorbidity between PMDD and BD is associated with worse clinical outcomes and increased illness burden. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MPS Artigos e Materiais de Revistas Científicas - HC/IPq Artigos e Materiais de Revistas Científicas - LIM/21 Artigos e Materiais de Revistas Científicas - ODS/03 |
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