Abstract
Objective: Premenstrual symptoms are seen in most of the women in reproductive age. These symptoms not only effect women’s mental state and functionality but also their personal relations. The relationship between premenstrual symptoms and mood disorders are quite complex. In DSM-5, Premenstrual Dysphoric Syndrome is classified under depressive disorders and it is suggested as a comorbidity with mood disorders or exacerbation of current mood disorder. Apart from the active episodes, what kind of problems do patients with mood disorders experience? Is exacerbation of symptoms or an increase in frequency of premenstrual dysphoric syndrome seen more compared to healthy controls is? In this present study, we tried to find answers for these questions.
Methods: Women with bipolar euthymic (n=23) or major depressive disorder in remission (n=23) who were registered at Mersin University Research and Practice Hospital Psychiatry Outpatient Clinic of were included in this study, as well as 23 healthy control women. Sociodemographic data and clinical features regarding the course of the disorders were noted. All subjects were administered Premenstrual Assessment Form. Statistical analyses were performed with SPSS 11.5 and Chi Square, z test, ANOVA and Tukey HSD were used.
Findings: Premenstrual syndrome (PMS) was more frequent in the major depression group than the control group while its frequency in the bipolar group was similar to the control group. In the premenstrual assessment form; depressive mood/ loss of pleasure, hysteric features, hostility/ anger, impulsivity, organic mental features subscale scores, and the total score were higher in the depression group than the control group (p<0.05). In addition, depressive mood/ loss of pleasure subscale score was also higher in the depression group compared to the bipolar group (p=0.002). With respect to PMS severity, we found that the rate of subjects with “mild PMS” was higher in the control group (p=0.034), while that of with “severe PMS” was higher in the depression group (p=0.022). Regarding the bipolar patients, we found that the longer the duration of euthymic phase the lesser were the severity of PMS.
Conclusion: Premenstrual symptoms seem to be more severe in depressed patients even they are under treatment. We did not see any worsening of premenstrual symptoms in bipolar patients as we hypothesized initially. The reason might be the underlying neurobiological interactions in the brain with appropriate bipolar treatment. More studies are needed to understand the nature of this relationship.

Key words: bipolar disorder, major depressive disorder, premenstrual dysphoric disorder, menstruation