Work stress, premenstrual syndrome and dysphoric disorder: are there any associations?

Women with recurrent and severe symptoms are diagnosed as having premenstrual syndrome (PMS), and if they suffer from severe affective symptoms, a diagnosis of premenstrual dysphoric disorder (PMDD) is made. The purpose of this study was to determine the association of work stress with PMS and PMDD.

Fifty-five female medical students in their internship program (ten 24-hour shifts per month) and 38 third-year female medical students without any shift duties were asked to participate in this study. A questionnaire was used to record demographic information and a self-report inventory was used to measure 13 symptoms relevant to PMS and PMDD according to DSM-IV criteria. All participants were asked to complete the inventory every night around midnight for those on shifts or before going to bed at home for 60 consecutive nights.

Out of 55 volunteers in the shift-work group, 31 (56%) fulfilled the diagnostic criteria for PMS in contrast to 12 (32%) in the control group. The frequency of PMDD was 12 (22%) in the intern group and 5 (13%) in the control group. Twenty one students (55%) from the control group did not have PMS or PMDD, compared to 12 (22%) students from the shift workers. Decreased energy (70.9%) and irritability (65.4%) were the most frequent symptoms during the luteal phase in the shift-work group.

Work stress and an increase in responsibility may produce or exacerbate PMS. Self-help approaches to induce self-awareness, along with psychological and psychiatric interventions, may help susceptible women to overcome this cyclic condition in order to increase their productivity as well as their quality of life.