¿Vulnerabilidad cognitiva a la depresión o sobreestimación de los síntomas disfóricos premenstruales?

  1. Cristina Senín-Calderón
  2. María Claudia Scurtu
  3. Celia Ceballos-Munuera
  4. Salvador Perona-Garcelán
  5. Juan Francisco Rodríguez-Testal
Psicología conductual = behavioral psychology: Revista internacional de psicología clínica y de la salud

ISSN: 1132-9483

Year of publication: 2023

Volume: 31

Issue: 3

Pages: 479-500

Type: Article

More publications in: Psicología conductual = behavioral psychology: Revista internacional de psicología clínica y de la salud


True premenstrual dysphoric disorder (PMDD) is hard to diagnose. It has been suggested that women’s expectations influence the symptoms of this disorder, which could increase their vulnerability to depression. This study aimed to estimate PMDD in a group of women by comparing their self-diagnosis with clinical evaluation; differentiate between PMDD symptoms and their intensity and its subthreshold form, determining its social-employment and relational consequences, finding differences in symptoms and vulnerability to depression; and identifying possible cognitive vulnerability to depression in PMDD. 105 women participated, 85 from the general population and 20 women with Major Depressive Disorder were selected. For the self-diagnosis, they filled out several self-reports and PMDD Criteria Indicators A, B, C (APA) and D (by author). The clinical diagnosis was made using a semi-structured interview following DSM-5 criteria. PMDD was overestimated when it was self-reported (51,76%) compared to clinical evaluation (5,88%). Therefore, retrospective and self-reported evaluation could bias what they remember and overestimate the indicators of the disorder and their severity. Cognitive vulnerability to depression for PMDD was not supported

Bibliographic References

  • Albsoul-Younes, A., Alefishat, E., Farha, R. A., Tashman, L., Hijjih, E. y AlKhatib, R. (2017).
  • Premenstrual syndrome and premenstrual dysphoric disorders among Jordanian women. Perspectives in Psychiatric Care, 54(3), 348-353. doi: 10.1111/ppc.12252
  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5ª ed.) (DSM-5). American Psychiatric Association.
  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5ª ed. Tex. Rev.) (DSM-5-TR). American Psychiatric Association.
  • Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. Harper and Row.
  • Beck, A. T., Epstein, N., Brown, G. y Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897. doi: 10.1037/0022-006X.56.6.893
  • Beck, A. T., Rush, A. J., Shaw, B. F. y Emery, G. (1979). Cognitive therapy of depression. Guilford.
  • Beddig, T. y Kuehner, C. (2017). Aktuelle aspekte zur prämenstruellen dysphorischen störung – ein überblick [Current aspects of premenstrual dysphoric disorder – a review]. Psychotherapie, Psychosomatik, Medizinische Psychologie, 67(12), 504-513. doi: 10.1055/s-0043-113816
  • Beddig, T., Reinhard, I. y Kuehner, C. (2019). Stress, mood, and cortisol during daily life in women with premenstrual dysphoric disorder (PMDD). Psychoneuroendocrinology, 109, 104372. doi: 10.1016/j.psyneuen.2019.104372
  • Borenstein, J. E., Dean, B.B., Leifke, E., Korner, P. y Yonkers, K. A. (2007). Differences in symptom scores and health outcomes in premenstrual syndrome. Journal of Women’s Health, 16, 1139-1144. doi: 10.1089/jwh.2006.0230
  • Bosman, R. C., Jung, S. E., Miloserdov, K., Schoevers, R. A. y aan het Rot, M. (2016). Daily symptom ratings for studying premenstrual dysphoric disorder: a review. Journal of Affective Disorders, 189, 43-53. doi: 10.1016/j.jad.2015.08.063
  • Braverman, P. K. (2007). Premenstrual syndrome and premenstrual dysphoric disorder. Journal of Pediatric and Adolescent Gynecology, 20(1), 3-12. doi: 10.1016/j.jpag.2006.10.007
  • Browne, T. K. (2014). Is premenstrual dysphoric disorder really a disorder? Journal of Bioethical Inquiry, 12(2), 313-330. doi: 10.1007/s11673-014-9567-7
  • Cerqueira, R. O., Frey, B. N., Leclerc, E. y Brietzke, E. (2017). Vitex agnus castus for premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. Archives of Women’s Mental Health, 20(6), 713-719. doi: 10.1007/s00737-017-0791- 0
  • Chawla, A., Swindle, R., Long, S., Kennedy, S. y Sternfeld, B. (2002). Premenstrual dysphoric disorder: is there an economic burden of illness? Medical Care, 40, 1101-1112. doi: 10.1097/01.mlr.0000032191.26152.90
  • Cohen, L. S., Soares, C. N., Otto, M. W., Sweeney, B. H., Liberman, R. F. y Harlow, B. L. (2002). Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women. Journal of Affective Disorders, 70(2), 125-132. doi: 10.1016/s0165-0327(01)00458-x
  • Comasco, E., Kopp Kallner, H., Bixo, M., Hirschberg, A. L., Nyback, S., de Grauw, H., Epperson, C. N. y Sundström-Poromaa, I. (2021). Ulipristal acetate for treatment of premenstrual dysphoric disorder: a proof-of-concept randomized controlled trial. American Journal of Psychiatry, 178(3), 256-265. doi: 10.1176/appi.ajp.2020.20030286
  • Craner, J. R., Sigmon, S. T., Martinson, A. A. y McGillicuddy, M. L. (2014). Premenstrual disorders and rumination. Journal of Clinical Psychology, 70(1), 32-47. doi: 10.1002/jclp.22007
  • Craner, J. R., Sigmon, S. T. y Martinson, A. A. (2015). Self-focused attention in response to laboratory stressors among women with premenstrual disorders. Archives of Women’s Mental Health, 18(4), 595-606. doi: 10.1007/s00737-015-0505-4
  • Cunningham, J., Yonkers, K. A., O’Brien, S. y Eriksson, E. (2009). Update on research and treatment of premenstrual dysphoric disorder. Harvard Review of Psychiatry, 17(2), 120-137. doi: 10.1080/10673220902891836
  • Dawson, D. N., Eisenlohr-Moul, T. A., Paulson, J. L., Peters, J. R., Rubinow, D. R. y Girdler, S. S. (2017). Emotion-related impulsivity and rumination predict the perimenstrual severity and trajectory of symptoms in women with a menstrually related mood disorder. Journal of Clinical Psychology, 74(4), 579-593. doi: 10.1002/jclp.22522
  • Dennerstein, L., Lehert, P., Bäckström, T. C. y Heinemann, K. (2009). Premenstrual symptoms severity, duration and typology: an international cross-sectional study. Menopause International, 15(3), 120-126. doi: 10.1258/mi.2009.009030
  • Dubol, M., Epperson, C. N., Lanzenberger, R., Sundström-Poromaa, I. y Comasco, E. (2020). Neuroimaging premenstrual dysphoric disorder: a systematic and critical review. Frontiers in Neuroendocrinology, 57, 100838. doi: 10.1016/j.yfrne.2020.100838
  • Dusenbery, M. (2018). Doing harm: the truth about how bad medicine and lazy science leave women dismissed, misdiagnosed, and sick. HarperOne.
  • Endicott, J., Amsterdam, J., Eriksson, E., Frank, E., Freeman, E., Hirschfeld, R., Ling, F., Parry, B., Pearlstein, T., Rosenbaum, J., Rubinow, D., Schmidt, P., Severino, S., Steiner, M., Stewart, D. E. y Thys-jacobs, S. (1999). Is premenstrual dysphoric disorder a distinct clinical entity? Journal of Women’s Health y Gender-Based Medicine, 8(5), 663-679. doi: 10.1089/jwh.1.1999.8.663
  • Eysenck, H.J. y Eysenck, S.B.G. (1990). Cuestionario de personalidad E.P.I. (6ª ed). TEA. Fuentes-Márquez, S., Senín-Calderón, C., Rodríguez-Testal, J. F. y Carrasco-Ortiz, M. A.
  • (2015). Perceived experience of fatigue in clinical and general population: descriptors and associated reactivities. The Spanish Journal of Psychology, 18, 1-8. doi: 10.1017/sjp.2015.11.
  • Gallant, S. J., Popiel, D. A., Hoffman, D. M., Chakraborty, P. K. y Hamilton, J. A. (1992). Using daily ratings to confirm premenstrual syndrome/late luteal phase dysphoric
  • disorder. Part I. Effects of demand characteristics and expectations. Psychosomatic Medicine, 54(2), 149-166. doi: 10.1097/00006842-199203000-00003
  • Green, L. J., O’Brien, P. M. S., Panay, N., Craig, M. y on behalf of the Royal College of Obstetricians and Gynaecologists (2017). Management of premenstrual syndrome. BJOG 124:e73-e105. doi: 10.1111/1471-0528.14260
  • Hardy, C. y Hardie, J. (2017). Exploring premenstrual dysphoric disorder (PMDD) in the work context: a qualitative study. Journal of Psychosomatic Obstetrics y Gynecology, 38(4), 292-300. doi: 10.1080/0167482x.2017.1286473
  • Hartlage, S. A., Breaux, C. A. y Yonkers, K. A. (2013). Addressing concerns about the inclusion of premenstrual dysphoric disorder in DSM-5. The Journal of Clinical Psychiatry, 75(01), 70-76. doi: 10.4088/jcp.13cs08368
  • Henz, A., Ferreira, C. F., Oderich, C. L., Gallon, C. W., Castro, J. R. S., Conzatti, M., Fleck, M. P. A. y Wender, M. C. O. (2018). Premenstrual syndrome diagnosis: a comparative study between the Daily Record of Severity of Problems (DRSP) and the Premenstrual Symptoms Screening Tool (PSST). Revista Brasileira de Ginecologia e Obstetricia, 40(1), 20-25. doi: 10.1055/s-0037-1608672
  • Hoffmann, D. E. y Tarzian, A. J. (2001). The girl who cried pain: a bias against women in the treatment of pain. Journal of Law, Medicine y Ethics, 29(1), 13-27. doi: 10.1111/j.1748-720x.2001.tb00037.x
  • Ingram, R. E., Atchley, R. A. y Segal, Z. V. (2011). Vulnerability to depression: from cognitive neuroscience to prevention and treatment. Guilford.
  • Izadi, M. y Amiri, S. (2019). Personality characteristics in female students with premenstrual dysphoric disorder and premenstrual syndrome. Advances in Nursing and Midwifery, 28(3), 40-45.
  • Kleinstäuber, M., Schmelzer, K., Ditzen, B., Andersson, G., Hiller, W. y Weise, C. (2016). Psychosocial profile of women with premenstrual syndrome and healthy controls: a comparative study. International Journal of Behavioral Medicine, 23(6), 752-763. doi: 10.1007/s12529-016-9564-9
  • Li, H. J., Goff, A., Rudzinskas, S. A., Jung, Y., Dubey, N., Hoffman, J., Hipolito, D., Mazzu, M., Rubinow, D. R., Schmidt, P. J. y Goldman, D. (2021). Altered estradiol-dependent cellular Ca2+ homeostasis and endoplasmic reticulum stress response in premenstrual dysphoric disorder. Molecular Psychiatry. doi: 10.1038/s41380-021-01144-8
  • Magán, I., Sanz, J. y García-Vega, M.P. (2008). Psychometric properties of a Spanish version of the Beck Anxiety Inventory (BAI) in general population. The Spanish Journal of Psychology, 11, 626-640. doi: 10.1017/S1138741600004637
  • Marván, M.L. y Cortés-Iniestra, S. (2001). Women's beliefs about the prevalence of premenstrual syndrome and biases in recall of premenstrual changes. Health Psychology, 20, 276-280. doi: 10.1037//0278-6133.20.4.276
  • Meyer, T. J., Miller, M. L., Metger, R. L. y Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487-495.
  • Nash, H. C. y Chrisler, J. C. (1997). Is a little (psychiatric) knowledge a dangerous thing?: the impact of premenstrual dysphoric disorder on perceptions of premenstrual women. Psychology of Women Quarterly, 21(2), 315-322. doi: 10.1111/j.1471- 6402.1997.tb00115.x
  • Nogueira Pires, M. L. y Calil, H. M. (2000). Clinical utility of the premenstrual assessment form as an instrument auxiliary to the diagnosis of premenstrual dysphoric disorder. Psychiatry Research, 94(3), 211-219. doi: 10.1016/s0165-1781(00)00151-7
  • Osborn, E., Brooks, J., O’Brien, P. M. S. y Wittkowski, A. (2020). Suicidality in women with premenstrual dysphoric disorder: a systematic literature review. Archives of Women’s Mental Health, 24(2), 173-184. doi: 10.1007/s00737-020-01054-8
  • Osborn, E., Wittkowski, A., Brooks, J., Briggs, P. E. y O’Brien, P. M. S. (2020). Women’s experiences of receiving a diagnosis of premenstrual dysphoric disorder: a qualitative investigation. BMC Women’s Health, 20(1). https://doi.org/10.1186/s12905-020- 01100-8
  • Pearlstein, T., Yonkers, K. A., Fayyad, R. y Gillespie, J. A. (2005). Pretreatment pattern of symptom expression in premenstrual dysphoric disorder. Journal of Affective Disorders, 85, 275-282. doi: 10.1016/j.jad.2004.10.004
  • Pilver, C. E., Libby, D. J. y Hoff, R. A. (2012). Premenstrual dysphoric disorder as a correlate of suicidal ideation, plans, and attempts among a nationally representative sample. Social Psychiatry and Psychiatric Epidemiology, 48(3), 437-446. doi: 10.1007/s00127- 012-0548-z
  • Prasad, D., Wollenhaupt-Aguiar, B., Kidd, K. N., de Azevedo Cardoso, T. y Frey, B. N. (2021). Suicidal risk in women with premenstrual syndrome and premenstrual dysphoric disorder: a systematic review and meta-analysis. Journal of Women’s Health. doi: 10.1089/jwh.2021.0185
  • Raffi, E. y Freeman, M. P. (2018). Diagnosis, etiology, and treatment of premenstrual dysphoric disorder. DeckerMed Psychiatry. doi: 10.2310/psych.13018
  • Reed, G. M., First, M. B., Kogan, C. S., Hyman, S. E., Gureje, O., Gaebel, W., Maj, M., Stein, D. J., Maercker, A., Tyrer, P., Claudino, A., Garralda, E., Salvador‐Carulla, L., Ray, R., Saunders, J. B., Dua, T., Poznyak, V., Medina‐Mora, M. E., Pike, K. M.,… Saxena, S. (2019). Innovations and changes in the ICD‐11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry, 18(1), 3-19. doi: 10.1002/wps.20611
  • Reid, R. L. y Soares, C. N. (2018). Premenstrual dysphoric disorder: contemporary diagnosis and management. Journal of Obstetrics and Gynaecology Canada, 40(2), 215-223. doi: 10.1016/j.jogc.2017.05.018
  • Rodríguez-Testal, J.F. (2021). Registro diario para la disforia premenstrual. Registro de la propiedad intelectual RTA-02702-2021. Manuscrito Inédito.
  • Ryu, A. y Kim, T. H. (2015). Premenstrual syndrome: a mini review. Maturitas, 82(4), 436- 440. doi: 10.1016/j.maturitas.2015.08.010
  • Sandín, B., Chorot, P., Valiente, R. M. y Lostao, L. (2009) Validación española del cuestionario de preocupación PSWQ: estructura factorial y propiedades psicométricas. Revista de Psicopatología y Psicología Clínica, 14, 107-122. doi: 10.5944/rppc.vol.14.num.2.2009.4070
  • Sanz, J., Gutiérrez, S., Gesteira, C. y García-Vera, M. P. (2014). Criterios y baremos para interpretar el “Inventario de depresión de Beck-II” (BDI-II). Behavioral Psychology/Psicología Conductual, 22(1), 37-59.
  • Sigmon, S. T., Whitcomb-Smith, S. R., Rohan, K. J. y Kendrew, J. J. (2004). The role of anxiety level, coping styles, and cycle phase in menstrual distress. Journal of Anxiety Disorders, 18(2), 177-191. doi: 10.1016/s0887-6185(02)00243-8
  • Soares, C. N. y Zitek, B. (2008). Reproductive hormone sensitivity and risk for depression across the female life cycle: a continuum of vulnerability? Journal of Psychiatry and Neuroscience, 33(4), 331-343.
  • Studd, J. (2012). Severe premenstrual syndrome and bipolar disorder: a tragic confusion. Menopause International, 18(2), 82-86. doi: 10.1258/mi.2012.012018
  • Vázquez, C. y Sanz, J. (1997). Fiabilidad y valores normativos de la versión española del Inventario para la depresión de Beck de 1978. Clínica y Salud, 8, 403-422.
  • Weissman, A. y Beck, A.T. (1978). Development and validation of the Dysfunctional Attitudes Scale [Comunicación oral]. The meeting of the association for the Advacement of Behavior Therapy, Chicago, IL, Estados Unidos.
  • Welz, A., Huffziger, S., Reinhard, I., Alpers, G. W., Ebner-Priemer, U. y Kuehner, C. (2016). Anxiety and rumination moderate menstrual cycle effects on mood in daily life. Women y Health, 56(5), 540-560. doi: 10.1080/03630242.2015.1101739
  • Yan, H., Ding, Y. y Guo, W. (2021). Suicidality in patients with premenstrual dysphoric disorder – a systematic review and meta-analysis. Journal of Affective Disorders, 295, 339-346. doi: 10.1016/j.jad.2021.08.082
  • RECIBIDO: 24 de junio de 2022 ACEPTADO: 10 de diciembre de 2022