ISPMD consensus on the management of premenstrual disorders

The second consensus meeting of the International Society for Premenstrual Disorders (ISPMD) took place in London during March 2011. The primary goal was to evaluate the published evidence and consider the expert opinions of the ISPMD members to reach a consensus on advice for the management of premenstrual disorders. Gynaecologists, psychiatrists, psychologists and pharmacologists each formally presented the evidence within their area of expertise; this was followed by an in-depth discussion leading to consensus recommendations. This article provides a comprehensive review of the outcomes from the meeting. The group discussed and agreed that careful diagnosis based on the recommendations and classification derived from the first ISPMD consensus conference is essential and should underlie the appropriate management strategy. Options for the management of premenstrual disorders fall under two broad categories, (a) those influencing central nervous activity, particularly the modulation of the neurotransmitter serotonin and (b) those that suppress ovulation. Psychotropic medication, such as selective serotonin reuptake inhibitors, probably acts by dampening the influence of sex steroids on the brain. Oral contraceptives, gonadotropin-releasing hormone agonists, danazol and estradiol all most likely function by ovulation suppression. The role of oophorectomy was also considered in this respect. Alternative therapies are also addressed, with, e.g. cognitive behavioural therapy, calcium supplements and Vitex agnus castus warranting further exploration

Suppression, Acceptance, and Monitoring of Personally-Relevant Unwanted Thoughts in Women Diagnosed with Borderline Personality Disorder

Recent evidence suggests that patients with Borderline Personality Disorder (BPD) experience less immediate distress while suppressing unwanted thoughts, despite the negative long-term outcomes of that strategy longitudinally and in treatment settings. The present study investigated the impact of 8-minute audiotaped suppression/thought control, acceptance, and monitoring instructions on moderately distressing and personally relevant thoughts in women (N = 51; 17 per condition) diagnosed with BPD. Strategies were applied in a 5-minute think-aloud period, followed by a similar period without the strategy, and then a wind-down task. Those in the suppression condition reported less subjective distress throughout but showed evidence of attempts at distraction through increased talking in the second period. Participants in the suppression group with higher experiential avoidance showed more thought intrusions during the main task period and lower positive affect during the wind-down task than those in other conditions. Suppression appears to produce some negative outcomes in this population despite resulting in less self-reported distress. (C) Copyright 2015 Textrum Ltd. All rights reserved