Associação entre Transtorno Disfórico Pré-menstrual e Transtornos Depressivos

Abstract

O Transtorno Disfórico Pré-menstrual (TDPM) é caracterizado por uma constelação de sintomas emocionais e alterações comportamentais, que se manifesta com um padrão temporal cíclico em associação com o período pré-menstrual. A validade de uma categoria diagnóstica psiquiátrica distinta para TDPM ainda é uma questão controversa. Entretanto, inúmeros estudos têm documentado uma associação específica entre mudanças pré-menstruais e transtornos depressivos. A presente revisão tem como objetivo sintetizar os resultados a respeito da semelhança dos sintomas depressivos no TDPM e nos transtornos depressivos, co-morbidade, história familiar e variáveis biológicas. Evidências de que os sintomas pré-menstruais seriam expressão de vulnerabilidade ao desenvolvimento de estados disfóricos (depressão e ansiedade), assim como as implicações diagnósticas dessa proposta são comentados.<br>Premenstrual Dysphoric Disorder (PMDD) is characterised by a myriad of emotional symptoms and behavioural alterations, which occur with a cyclic temporal pattern associated with the pre-menstrual period. The validity of an isolated psychiatric diagnostic category for PMDD remains controversial. However, research results have been showing a specific association between pre-menstrual changes and depressive disorder. The present review has as objective to sintethise the results on similarity between depressive symptoms in PMDD and in the depressive disorders, comorbidity, family history and biological variables. Evidences suggesting that the pre-menstrual symptoms would be expression of a vulnerability to the development of dysphoric states (depression and anxiety) as well as diagnostic implications of such proposals are discussed

Association between Premenstrual Dysphoric Disorder and Systemic Lupus Erythematosus: Exacerbation of Major Depression Symptoms?

“…Although menstruation is an important event in a woman's reproductive cycle, it may interfere with various aspects of her life, since at these periods she tends to engage in more family conflicts, place less emphasis on objective or intellectual values, and lose autonomy and innovation in her field of work [27]. Most women do not accurately report the onset of symptoms, which leads one to believe the syndrome is an insidious process [28] and mainly identify it after it has become exacerbated in situations of anxiety, fear, and stress [21,28]. Generally, women seek treatment about ten years after the onset of symptoms, when they will be more intense and have longer duration with the passing years, as well as history of more occupational damage [28].…”

“…In patients with SLE, this distinction becomes even more difficult since the prevalence of psychiatric symptoms, including depression, is high [3,23]. Women with mood disorders are prone to an exacerbation of the affective symptoms during the premenstrual period [17], and history of previous depression could influence the severity and duration of depressive symptoms in the premenstrual period, resulting in an association with PMDD [30,21,16]. The symptoms of irritability and nervousness, besides depressed mood, are recurrent in PMDD and are common characteristics in cases of atypical depression [11,27,31].…”

“…Frequency of PMS and PMDD seems to be higher in patients with major depressive disorder, compared to groups without psychiatric history [19,20], and the affective symptoms (depression, irritability, anxiety) are the most striking concern of these menstrual cycle problems [21]. However, this interaction has not yet been studied in SLE.…”

Repercussões do transtorno disfórico pré-menstrual entre universitárias

“…Este fato também é apontado em outros trabalhos que avaliaram os sintomas pré-menstruais e suas repercussões no cotidiano das mulheres, enfatizando que os sintomas de alteração de humor podem provocar prejuízo ou mesmo necessidade de interrupção dos compromissos, gerando problemas no relacionamento familiar e social, bem como difi culdades no desempenho acadê-mico e/ou profi ssional 1,3,7,14 .…”

“…Além disso, causa um forte comprometimento do funcionamento social e ocupacional do indivíduo, que geralmente pioram com a aproximação da menstruação e usualmente cessam de forma imediata com o início do fl uxo menstrual 7 .…”