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October 14, 1992, Vol 268, No. 14 >
ARTICLE | October 14, 1992

The Premenstrual Syndrome: Title and subTitle BreakNew Views FREE

David R. Rubinow, MD
[+] Author Affiliations

Reprint requests to the Office of the Clinical Director, National Institute of Mental Health, Bldg 10, Room 3N238, 9000 Rockville Pike, Bethesda, MD 20892 (Dr Rubinow).


JAMA. 1992;268(14):1908-1912. doi:10.1001/jama.1992.03490140116046
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References

CASE PRESENTATION  A 30-year-old married mother of four was referred to the National Institute of Mental Health for a cyclic mood disorder. She observed that over the preceding 7 years she experienced mood and somatic symptoms seemingly related to her menstrual cycle. Approximately 9 days before her menses, she would become sad and cry, want to be alone, and experience sensitivity to rejection, guilt, self-criticism, and occasional suicidal ideation. These symptoms were not responsive to expressed concern from others. Rather, she attempted to isolate herself because she became profoundly irritable around others and demonstrated anger, impatience, "meanness," overreactivity, and verbal outbursts. Her verbal loss of control caused problems at work and in her relationships with her family. Other symptoms included a decrease in her general level of interest and energy, an inability to initiate activities or to experience pleasure, fatigue, disturbed sleep, distractibility, indecisiveness, and increased appetite and food intake

REFERENCES

1 +
Rubinow DR, Roy-Byrne PP, Hoban MC, Gold PW, Post RM.  Prospective assessment of menstrually related mood disorders. Am J Psychiatry . 1984;;141:684-686.
2 +
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington, DC: American Psychiatric Association; 1987;.
3 +
National Institute of Mental Health. NIMH Premenstrual Syndrome Workshop Guidelines, April 14-15, 1983 . Rockville, Md: National Institute of Mental Health; 1983;.
4 +
Rivera-Tovar AD, Frank E.  Late luteal phase dysphoric disorder in young women. Am J Psychiatry . 1990;;147:1634-1636.
5 +
Schnurr PP.  Measuring amount of symptom change in the diagnosis of premenstrual syndrome. Psychol Assess . 1989;;1:277-283.
6 +
Rubinow DR, Hoban MC, Grover GN, et al.  Changes in plasma hormones across the menstrual cycle in patients with menstrually related mood disorder and in control subjects. Am J Obstet Gynecol . 1988;;158:5-11.
7 +
Reame NE, Marshall JC, Kelch RP.  Pulsatile LH secretion in women with premenstrual syndrome: evidence for normal neuroregulation of the menstrual cycle. Psychoneuroendocrinology . In press.
8 +
Facchinetti F, Genazzani AD, Martignoni E, Fioroni L, Sances G, Genazzani AR.  Neuroendocrine correlates of premenstrual syndrome: changes in the pulsatile pattern of plasma LH. Psychoneuroendocrinology . 1990;;15:269-277.
9 +
Reid RL.  Neuropeptides and PMS. Fertil Steril . 1986;;46:738.
10 +
Roy-Byrne PP, Rubinow DR, Hoban MC, Grover GN, Blank D.  TSH and prolactin responses to TRH in patients with premenstrual syndrome. Am J Psychiatry . 1987;;144:480-484.
11 +
Lee KA, Shaver JF, Giblin EC, Woods NF.  Sleep patterns related to menstrual cycle phase and premenstrual affective symptoms. Sleep . 1990;;13:403-409.
12 +
Parry BL, Berga SL, Kripke DF, et al.  Altered waveform of plasma nocturnal melatonin secretion in premenstrual syndrome. Arch Gen Psychiatry . 1990;;47:1139-1146.
13 +
Parry BL, Mendelson WB, Duncan WB, Sack DA, Wehr TA.  Longitudinal sleep EEG, temperature, and activity measurements across the menstrual cycle in patients with premenstrual depression and in age-matched controls. Psychiatry Res . 1989;;30:285-303.
14 +
Sherwood RA, Rocks BF, Stewart A, Saxton RS.  Magnesium and the premenstrual syndrome. Ann Clin Biochem . 1986;;23:667-670.
15 +
Rosenstein DL, Hosseini JM, Elin RJ, Rubinow DR. Magnesium in menstrual-related mood disorders. In: New research program and abstracts of the 145th annual meeting of the American Psychiatric Association; May 2-7, 1992; Washington, DC. Abstract NR82.
16 +
Bancroft J, Cook A, Davidson D, Bennie J, Goodwin G.  Blunting of neuroendocrine responses to infusion of L-tryptophan in women with perimenstrual mood change. Psychol Med . 1991;;21:305-312.
17 +
Rabin DS, Schmidt PJ, Campbell G, et al.  Hypothalamic-pituitary-adrenal function in patients with the premenstrual syndrome. J Clin Endocrinol Metab . 1990;;71:1158-1162.
18 +
Facchinetti F, Martignoni E, Petraglia F, Sances M, Nappi G, Genazzani A.  Premenstrual fall of plasma β-endorphin in patients with premenstrual syndrome. Fertil Steril . 1987;;47: 570-573.
19 +
Chuong CJ, Coulam CB, Kao PC, Bergstralh E, Go VL.  Neuropeptide levels in premenstrual syndrome. Fertil Steril . 1985;;44:760-765.
20 +
Taylor DL, Mathew RJ, Ho BT, Weinman ML.  Serotonin levels and platelet uptake during premenstrual tension. Neuropsychobiology . 1984;; 12:16-18.
21 +
Ashby CR Jr, Carr LA, Cook CL, Steptoe MM, Franks DD.  Alteration of platelet serotonergic mechanism and monoamine oxidase activity in premenstrual syndrome. Biol Psychiatry . 1988;;24:225-233.
22 +
Malmgren R, Collins A, Nilsson CG.  Platelet serotonin uptake and effects of vitamin B6 treatment in premenstrual tension. Neuropsychobiology . 1987;;18:83-88.
23 +
Veeninga AT, Westenberg HGM.  Serotonergic function and late luteal phase dysphoric disorder. Psychopharmacology . In press.
24 +
Tulenheimo A, Laatikainen T, Salminen K.  Plasma β-endorphin immunoreactivity in premenstrual tension. Br J Obstet Gynaecol . 1987;; 94:26-29.
25 +
Hamilton JA, Gallant S.  Premenstrual symptom changes and plasma β-endorphin/ β-lipotropin throughout the menstrual cycle. Psychoneuroendocrinology . 1988;;13:505-514.
26 +
Schmidt PJ, Nieman LK, Grover GN, Muller KL, Merriam GR, Rubinow DR.  Lack of effect of induced menses on symptoms in women with premenstrual syndrome. N Engl J Med . 1991;; 324:1174-1179.
27 +
Casson P, Hahn PM, VanVugt DA, Reid RL.  Lasting response to ovariectomy in severe intractable premenstrual syndrome. Am J Obstet Gynecol . 1990;;162:99-105.
28 +
Schachter S, Singer JE.  Cognitive, social, and physiological determinants of emotional state. Psychol Rev . 1962;;69:379-399.
29 +
Porrino LJ. Neurochemical studies of brain reward systems. In: Abstracts of the 26th annual meeting of the American College of Neuropsychopharmacology; December 7-11, 1987; San Juan, Puerto Rico:18.
30 +
Weiss SR, Post RM, Pert A, Woodward R, Murman D.  Context-dependent cocaine sensitization: differential effect of haloperidol on development versus expression. Pharmacol Biochem Behav . 1989;;34:655-661.
31 +
Paddison PL, Gise LH, Lebovits A, Strain JJ, Cirasole DM, Levine JP.  Sexual abuse and premenstrual syndrome: comparison between a lower and higher socioeconomic group. Psychosomatics . 1990;;31:265-272.
32 +
Schmidt PJ, Rosenfeld D, Muller KL, Grover GN, Rubinow DR.  A case of autoimmune thyroiditis presenting as menstrual-related mood disorder. J Clin Psychiatry . 1990;;51:434-436.
33 +
Muse KN, Cetel NS, Futterman LA, Yen SSC.  The premenstrual syndrome: effects of 'medical ovariectomy.' N Engl J Med . 1984;;311: 1345-1349.
34 +
Casper RF, Hearn MT.  The effect of hysterectomy and bilateral oophorectomy in women with severe premenstrual syndrome. Am J Obstet Gynecol . 1990;;162:105-109.
35 +
Stone AB, Pearlstein TB, Brown WA.  Fluoxetine in the treatment of premenstrual syndrome. Psychopharmacol Bull . 1990;;26:331-335.

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1 +
Rubinow DR, Roy-Byrne PP, Hoban MC, Gold PW, Post RM.  Prospective assessment of menstrually related mood disorders. Am J Psychiatry . 1984;;141:684-686.
2 +
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised . Washington, DC: American Psychiatric Association; 1987;.
3 +
National Institute of Mental Health. NIMH Premenstrual Syndrome Workshop Guidelines, April 14-15, 1983 . Rockville, Md: National Institute of Mental Health; 1983;.
4 +
Rivera-Tovar AD, Frank E.  Late luteal phase dysphoric disorder in young women. Am J Psychiatry . 1990;;147:1634-1636.
5 +
Schnurr PP.  Measuring amount of symptom change in the diagnosis of premenstrual syndrome. Psychol Assess . 1989;;1:277-283.
6 +
Rubinow DR, Hoban MC, Grover GN, et al.  Changes in plasma hormones across the menstrual cycle in patients with menstrually related mood disorder and in control subjects. Am J Obstet Gynecol . 1988;;158:5-11.
7 +
Reame NE, Marshall JC, Kelch RP.  Pulsatile LH secretion in women with premenstrual syndrome: evidence for normal neuroregulation of the menstrual cycle. Psychoneuroendocrinology . In press.
8 +
Facchinetti F, Genazzani AD, Martignoni E, Fioroni L, Sances G, Genazzani AR.  Neuroendocrine correlates of premenstrual syndrome: changes in the pulsatile pattern of plasma LH. Psychoneuroendocrinology . 1990;;15:269-277.
9 +
Reid RL.  Neuropeptides and PMS. Fertil Steril . 1986;;46:738.
10 +
Roy-Byrne PP, Rubinow DR, Hoban MC, Grover GN, Blank D.  TSH and prolactin responses to TRH in patients with premenstrual syndrome. Am J Psychiatry . 1987;;144:480-484.
11 +
Lee KA, Shaver JF, Giblin EC, Woods NF.  Sleep patterns related to menstrual cycle phase and premenstrual affective symptoms. Sleep . 1990;;13:403-409.
12 +
Parry BL, Berga SL, Kripke DF, et al.  Altered waveform of plasma nocturnal melatonin secretion in premenstrual syndrome. Arch Gen Psychiatry . 1990;;47:1139-1146.
13 +
Parry BL, Mendelson WB, Duncan WB, Sack DA, Wehr TA.  Longitudinal sleep EEG, temperature, and activity measurements across the menstrual cycle in patients with premenstrual depression and in age-matched controls. Psychiatry Res . 1989;;30:285-303.
14 +
Sherwood RA, Rocks BF, Stewart A, Saxton RS.  Magnesium and the premenstrual syndrome. Ann Clin Biochem . 1986;;23:667-670.
15 +
Rosenstein DL, Hosseini JM, Elin RJ, Rubinow DR. Magnesium in menstrual-related mood disorders. In: New research program and abstracts of the 145th annual meeting of the American Psychiatric Association; May 2-7, 1992; Washington, DC. Abstract NR82.
16 +
Bancroft J, Cook A, Davidson D, Bennie J, Goodwin G.  Blunting of neuroendocrine responses to infusion of L-tryptophan in women with perimenstrual mood change. Psychol Med . 1991;;21:305-312.
17 +
Rabin DS, Schmidt PJ, Campbell G, et al.  Hypothalamic-pituitary-adrenal function in patients with the premenstrual syndrome. J Clin Endocrinol Metab . 1990;;71:1158-1162.
18 +
Facchinetti F, Martignoni E, Petraglia F, Sances M, Nappi G, Genazzani A.  Premenstrual fall of plasma β-endorphin in patients with premenstrual syndrome. Fertil Steril . 1987;;47: 570-573.
19 +
Chuong CJ, Coulam CB, Kao PC, Bergstralh E, Go VL.  Neuropeptide levels in premenstrual syndrome. Fertil Steril . 1985;;44:760-765.
20 +
Taylor DL, Mathew RJ, Ho BT, Weinman ML.  Serotonin levels and platelet uptake during premenstrual tension. Neuropsychobiology . 1984;; 12:16-18.
21 +
Ashby CR Jr, Carr LA, Cook CL, Steptoe MM, Franks DD.  Alteration of platelet serotonergic mechanism and monoamine oxidase activity in premenstrual syndrome. Biol Psychiatry . 1988;;24:225-233.
22 +
Malmgren R, Collins A, Nilsson CG.  Platelet serotonin uptake and effects of vitamin B6 treatment in premenstrual tension. Neuropsychobiology . 1987;;18:83-88.
23 +
Veeninga AT, Westenberg HGM.  Serotonergic function and late luteal phase dysphoric disorder. Psychopharmacology . In press.
24 +
Tulenheimo A, Laatikainen T, Salminen K.  Plasma β-endorphin immunoreactivity in premenstrual tension. Br J Obstet Gynaecol . 1987;; 94:26-29.
25 +
Hamilton JA, Gallant S.  Premenstrual symptom changes and plasma β-endorphin/ β-lipotropin throughout the menstrual cycle. Psychoneuroendocrinology . 1988;;13:505-514.
26 +
Schmidt PJ, Nieman LK, Grover GN, Muller KL, Merriam GR, Rubinow DR.  Lack of effect of induced menses on symptoms in women with premenstrual syndrome. N Engl J Med . 1991;; 324:1174-1179.
27 +
Casson P, Hahn PM, VanVugt DA, Reid RL.  Lasting response to ovariectomy in severe intractable premenstrual syndrome. Am J Obstet Gynecol . 1990;;162:99-105.
28 +
Schachter S, Singer JE.  Cognitive, social, and physiological determinants of emotional state. Psychol Rev . 1962;;69:379-399.
29 +
Porrino LJ. Neurochemical studies of brain reward systems. In: Abstracts of the 26th annual meeting of the American College of Neuropsychopharmacology; December 7-11, 1987; San Juan, Puerto Rico:18.
30 +
Weiss SR, Post RM, Pert A, Woodward R, Murman D.  Context-dependent cocaine sensitization: differential effect of haloperidol on development versus expression. Pharmacol Biochem Behav . 1989;;34:655-661.
31 +
Paddison PL, Gise LH, Lebovits A, Strain JJ, Cirasole DM, Levine JP.  Sexual abuse and premenstrual syndrome: comparison between a lower and higher socioeconomic group. Psychosomatics . 1990;;31:265-272.
32 +
Schmidt PJ, Rosenfeld D, Muller KL, Grover GN, Rubinow DR.  A case of autoimmune thyroiditis presenting as menstrual-related mood disorder. J Clin Psychiatry . 1990;;51:434-436.
33 +
Muse KN, Cetel NS, Futterman LA, Yen SSC.  The premenstrual syndrome: effects of 'medical ovariectomy.' N Engl J Med . 1984;;311: 1345-1349.
34 +
Casper RF, Hearn MT.  The effect of hysterectomy and bilateral oophorectomy in women with severe premenstrual syndrome. Am J Obstet Gynecol . 1990;;162:105-109.
35 +
Stone AB, Pearlstein TB, Brown WA.  Fluoxetine in the treatment of premenstrual syndrome. Psychopharmacol Bull . 1990;;26:331-335.

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