The Continuum of Premenstrual Symptom Exacerbation in Women With and Without Psychiatric Comorbidities: A Nurses' Health Study

Abstract

Background: It is widely known that menstrual cycle fluctuations can significantly affect a woman's mood, behavior and quality of life over the course of her reproductive years, largely due to reproductive hormonal variations during the course of the menstrual cycle. In fact, women are twice as likely as men to experience a mood disorder. Approximately 85% percent of women experience some form of premenstrual symptom exacerbation (PME) and the majority experience symptoms, which are severe enough to interfere with their daily activities. Little is known, however, about the differences in symptom severity, stress, quality of life, healthy lifestyle and wellness self-perception among women who experience PME with and without psychiatric comorbidities. In addition, little is known about how psychiatric comorbidities affect severity of PME, stress, quality of life, healthy lifestyle and wellness self-perception. Methods: This study was conducted using a comparative descriptive design to compare premenstrual symptoms, stress, quality of life, healthy lifestyle and wellness self-perception among women experiencing PME and psychiatric comorbidities to women who experience PME without psychiatric comorbidities. Women with PME were recruited from various nursing organizations using secure online surveys. After collection of socio-demographic information, premenstrual symptom severity was measured with the Premenstrual Symptoms Screening Tool (PSST), stress with the Perceived Stress Scale (PSS), quality of life with the Quality of Life Scale (QOLS) and healthy lifestyle and wellness self-perception were assessed using the Healthy Lifestyle Questionnaire (HLQ) & Wellness Self-Perception Scale (WSPS). Data Analysis: The data was cleaned, coded and assessed for outliers and shape of distribution prior to data analysis. Analysis included descriptive statistics to describe key characteristics of the sample, and inferential statistics to test the hypotheses. Results: After controlling for diet, exercise, sleep and caffeine intake, psychiatric comorbidities predicted greater PME symptom severity (β=0.22; T=2.45; P=0.02), higher perceived stress (β=0.25; T=2.61; P=0.01), and lower levels of wellness self-perception (β= -0.30; T= -3.14; P=0.00). Psychiatric comorbidities did not predict quality of life (β= -0.13; T= -1.28; P=0.20) or healthy lifestyle (β= -0.13; T= -1.43; P=0.16). Significance: These findings may inform novel pharmacologic and non-pharmacologic interventions and treatment guidelines to achieve optimal symptom management, reduce stress and improve wellness self-perception among women with PME and psychiatric comorbidities.Dr.N.P., Nursing Practice -- Drexel University, 201