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Vol. 69, No. 1, 2000
Issue release date: January–February 2000

Personality Disorders and Depressive Symptoms in Late Luteal Phase Dysphoric Disorder

De Ronchi D. · Muro A. · Marziani A. · Rucci P.
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Abstract

Background: Although many significant studies of late luteal phase dysphoric disorder (LLPD) have been carried out, some conflicting findings on the relationships between personality disorders, depressive symptoms, hostility and LLPD deserve further investigation. Methods: Forty-three LLPD patients and 85 control subjects, evaluated by prospective daily ratings during two symptomatic cycles, received a detailed psychiatric evaluation, including the sections for psychotic, affective and anxiety disorders of the Structured Clinical Interview for DSM-III-R nonpatient version and the section for personality disorders; the Buss Durkee Inventory for Assessing Different Kinds of Hostility and the Montgomery-Åsberg Depression Rating Scale. Results: The odds of suffering from LLPD are about nine-fold (crude odds ratio, OR = 9.23, 95% confidence interval, CI 3.98–21.39) among women with mild or moderate depressive symptoms. When two age strata (below and above 30) are analyzed separately, the association between LLPD and depressive symptoms is strong and positive in both strata, while the association between LLPD and avoidant personality disorder is found only among older women (adjusted OR = 8.26, p < 0.05, 95% CI 1.03–66.35). Conclusions: The major finding from this preliminary study is the association between LLPD and depressive symptoms. Conversely, the association between LLPD and avoidant personality disorder remains controversial and seems to be dependent on age. Our findings support the hypothesis that LLPD and avoidant personality disorder may be considered as part of the spectrum of recurrent mood disorder rather than as qualitatively distinct nosological entities. Future studies are needed, adopting prospective, longitudinal assessments of personality prior to the onset of LLPD.

Copyright © 2000 S. Karger AG, Basel



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References

  1. Bancroft J: The premenstrual syndrome – A reappraisal of the concept and the evidence. Psychol Med 1993(suppl 24):1–47.
  2. Frank RT: The hormonal causes of premenstrual tension. Arch Neurol Psych 1931;26:1053–1057.
  3. de Girolamo G, Marchitelli G, Corbani R, Palazzi S: Premenstrual symptoms and psychiatric morbidity in two Italian health care settings. Psychother Psychosom 1989;52:187–196.

    External Resources

  4. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 3 revised. Washington, American Psychiatric Association, 1987.
  5. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 1994.
  6. Bancroft J, Rennie D: Perimenstrual depression: Its relationship to pain, bleeding, and previous history of depression. Psychosom Med 1995;57:445–452.
  7. Kashiwagi T, McClure JN, Wetzell RD: Premenstrual affective syndrome and psychiatric disorder. Dis Nerv Syst 1976;37:116–119.

    External Resources

  8. Endicott J: The menstrual cycle and mood disorders. J Affect Disord 1993;29:193–200.
  9. Halbreich U, Endicott J: Relationship of dysphoric premenstrual changes to depressive disorders. Acta Psychiatr Scand 1985;71:331–338.
  10. Mackenzie TB, Wilcox K, Baron H: Lifetime prevalence of psychiatric disorders in women with perimenstrual difficulties. J Affect Disord 1986;10:15–19.
  11. Stout AL, Steege JF, Blazer DG, George LK: Comparison of lifetime psychiatric diagnoses in Premenstrual Syndrome Clinic and community samples. J Nerv Ment Dis 1986;174:517–522.

    External Resources

  12. Warner P, Bancroft J, Dixson A, Hampson M: The relationship between perimenstrual depressive mood and depressive illness. J Affect Disord 1991;23:9–23.
  13. Bloch M, Schmidt PJ, Rubinow DR: Premenstrual syndrome: Evidence for symptom stability across cycles. Am J Psychiatry 1997;154:1741–1746.
  14. Halbreich U: Premenstrual dysphoric disorders: A diversified cluster of vulnerability traits to depression. Acta Psychiatr Scand 1997;95:169–176.
  15. Yonkers KA: The association between premenstrual dysphoric disorder and other mood disorders. J Clin Psychiatry 1997;58(suppl 15):19–25.
  16. Halbreich U: Premenstrual dysphoric disorders, anxiety, and depressions: Vulnerability traits or comorbidity. Arch Gen Psychiatry 1995;52:606.

    External Resources

  17. Kaspi SP, Otto MW, Pollacj MH, Eppinger S, Rosenbaum JF: Premenstrual exacerbation of symptoms in women with panic disorder. J Anxiety Disord 1994;8:131–138.

    External Resources

  18. Sigmon ST, Fink CM, Rohan KJ, Hotovy LA: Anxiety sensitivity and menstrual cycle reactivity: Psychophysiological and self-report differences. J Anxiety Disord 1996;10:393–410.
  19. Veeninga AT: The relationships between late luteal phase dysphoric disorder and anxiety disorders. J Anxiety Disord 1994;8:207–216.

    External Resources

  20. Yonkers KA: Anxiety symptoms and anxiety disorders: How are they related to premenstrual disorders? J Clin Psychiatry 1997;58 (suppl 3):62–67.
  21. Facchinetti F, Fioroni L, Martignoni E, Sances G, Costa A, Genazzani AR: Changes of opioid modulation of the hypothalamo-pituitary-adrenal axis in patients with severe premenstrual syndrome. Psychosom Med 1994;56:418–422.
  22. Fava M, Pedrazzi F, Guaraldi GP: Comorbid anxiety and depression among patients with late luteal phase dysphoric disorder. J Anxiety Disord 1992;6:325–335.

    External Resources

  23. Keuthen NJ, O’Sullivan RL, Hayday CF, Peets KE, Jenike MA, Baer L: The relationship of menstrual cycle and pregnancy to compulsive hairpulling. Psychother Psychosom 1997;66:33–37.
  24. Bancroft J, Rennie D, Warner P: Vulnerability to perimenstrual mood change: The relevance of a past history of depressive disorder. Psychosom Med 1994;56:225–231.
  25. Goldberg DP, Huxley P: Common Mental Disorders: A Biosocial Model. London, Routledge, 1991.
  26. Coppen A, Kessel N: Menstruation and personality. Br J Psychiatry 1963;109:711–721.

    External Resources

  27. Mira M, Vizzard J, Abraham S: Personality characteristics in the menstrual cycle. J Psychosom Obstet Gynaecol 1985;4:329–334.
  28. Freeman EW, Schweizer E, Rickels K: Personality factors in women with premenstrual syndrome. Psychosom Med 1995;57:453–459.
  29. Ussher JM, Wilding JM: Interactions between stress and performance during the menstrual cycle in relation to the premenstrual syndrome. J Reprod Infant Psychol 1992;10:83–101.
  30. Hallman J, Oreland L, Edmand G, Schalling D: Thrombocyte monoamine oxidase activity and personality traits in women with severe premenstrual syndrome. Acta Psychiatr Scand 1987;76:225–234.

    External Resources

  31. Taylor RJ, Fordyce ID, Alexander DA: Relationship between personality and premenstrual symptoms: A study in five general practices. Br J Gen Pract 1991;41:55–57.
  32. Hammarback S, Backstrom T: A demographic study in subgroups of women seeking help for premenstrual syndrome. Acta Obstet Gynecol Scand 1989;68:247–253.

    External Resources

  33. Pearlstein TB, Frank E, Rivera-Tovar A, Thoft JS, Jacobs E, Mieczkowski TA: Prevalence of axis I and axis II disorders in women with late luteal phase dysphoric disorder. J Affect Disord 1990;20:129–134.
  34. Eckerd MB, Hurt SW, Severino SK: Late luteal phase dysphoric disorder: Relationship to personality disorders. J Pers Disord 1989;3:338–344.
  35. Parry BL, Ehlers CL, Mostofi N, Phillips E: Personality traits in LLPDD and normal controls during follicular and luteal menstrual-cycle phases. Psychol Med 1996;26:197–202.
  36. Miller TQ, Markides KS, Chiriboga DA, Ray LA: A test of the psychosocial vulnerability and health behavior models of hostility: Results from an 11-year follow-up study of Mexican Americans. Psychosom Med 1995;57:572–581.
  37. Spitzer RL, Williams JB, Gibbon M, First MB: The Structured Clinical Interview for DSM-III-R (SCID). I. History, rationale, and description. Arch Gen Psychiatry 1992;49:624–629.
  38. Spitzer RL, Williams JBW, Gibbon M: Structured Clinical Interview for the DSM-III-R Personality Disorders (SCID-II). Washington, American Psychiatric Association, 1987.
  39. Montgomery SA, Åsberg M: A new depression scale designed to be sensitive to change. Br J Psychiatry 1979;134:382–389.
  40. Buss AH, Durkee A: An inventory for assessing different kinds of hostility. J Consult Psychol 1957;21:343–348.
  41. Warner P, Bancroft J: Factors related to self-reporting of the pre-menstrual syndrome. Br J Psychiatry 1990;157:249–260.
  42. Hurt SW, Schnurr PP, Severino SK, Freeman EW, Gise LH, Rivera-Tovar A, Steege JF: Late luteal phase dysphoric disorder in 670 women evaluated for premenstrual complaints. Am J Psychiatry 1992;149:525–530.
  43. Norusis MJ: SPSS/PC+ Advanced Statistics. Chicago, SPSS Inc, 1988.
  44. Freeman EW, Rickels K, Schweizer E, Ting T: Relationships between age and symptom severity among women seeking medical treatment for premenstrual symptoms. Psychol Med 1995;25:309–315.
  45. Alpert JE, Uebelacker LA, McLean NE, Nierenberg AA, Pava JA, Worthington JJ 3rd, Tedlow JR, Rosenbaum JF, Fava M: Social phobia, avoidant personality disorder and atypical depression: Co-occurrence and clinical implications. Psychol Med 1997;27:627–633.
  46. Sanderson WC, Wetzler S, Beck AT, Betz F: Prevalence of personality disorders in patients with major depression and dysthymia. Psychiatry Res 1992;42:93–99.
  47. Shea MT, Leon AC, Mueller TI, Solomon DA, Warshaw MG, Keller MB: Does major depression result in lasting personality change? Am J Psychiatry 1996;153:1404–1410.
  48. Pepper CM, Klein DN, Anderson RL, Riso LP, Ouimette PC, Lizardi H: DSM-III-R axis II comorbidity in dysthymia and major depression. Am J Psychiatry 1995;152:239–247.
  49. Kuczmierczyk AR, Johnson CC, Labrum AH: Coping styles in women with premenstrual syndrome. Acta Psychiatr Scand 1994;89:301–305.
  50. Joffe RT, Bagby RM, Levitt AJ, Regan JJ, Parker JD: The Tridimensional Personality Questionnaire in major depression. Am J Psychiatry 1993;150:959–960.
  51. Brown SL, Svrakic DM, Przybeck TR, Cloninger CR: The relationship of personality to mood and anxiety states: A dimensional approach. J Psychiatr Res 1992;26:197–211.
  52. Saviotti FM, Grandi S, Savron G, Ermentini R, Bartolucci G, Conti S, Fava GA: Characterological traits of recovered patients with panic disorder and agoraphobia. J Affect Disord 1991;23:113–117.
  53. Pfohl B, Black D, Noyes R Jr, Kelley M, Blum N: A test of the tridimensional personality theory: Association with diagnosis and platelet imipramine binding in obsessive-compulsive disorder. Biol Psychiatry 1990;28:41–46.
  54. Zimmerman M: Diagnosing personality disorders. A review of issues and research methods. Arch Gen Psychiatry 1994;51:225–245.
  55. Dalton K: Premenstrual syndrome: An alternative view. Br J Hosp Med 1991;45:341.
  56. Bancroft J, Williamson L, Warner P, Rennie D, Smith SK: Perimenstrual complaints in women complaining of PMS, menorrhagia, and dysmenorrhea: Toward a dismantling of the premenstrual syndrome. Psychosom Med 1993;55:133–145.
  57. Akiskal HS, Hirschfeld RM, Yerevanian BI: The relationship of personality to affective disorders. Arch Gen Psychiatry 1983;40:801–810.

    External Resources

  58. Hirschfeld RM, Klerman GL, Lavori P, Keller MB, Griffith P, Coryell W: Premorbid personality assessments of first onset of major depression. Arch Gen Psychiatry 1989;46:345–350.
  59. Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ: A longitudinal twin study of personality and major depression in women. Arch Gen Psychiatry 1993;50:853–862.
  60. Johnson JG, Williams JB, Goetz RR, Rabkin JG, Remien RH, Lipsitz JD, Gorman JM: Personality disorders predict onset of Axis I and disorders and impaired functioning among homosexual men with and at risk of HIV infection. Arch Gen Psychiatry 1996;53:350–357.
  61. Gunderson JG, Links PS, Reich JH: Competing models of personality disorders. J Pers Disord 1991;5:60–68.


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