Evaluating Premenstrual Dysphoric Disorder in Women With Rheumatoid Arthritis and Healthy Female Subjects

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome that profoundly impacts daily functioning and quality of life. Rheumatoid arthritis (RA) is a chronic inflammatory disease primarily affecting joints and may also influence mental health, potentially increasing the risk of PMDD. This study aims to assess the prevalence and severity of PMDD in women with RA compared with the general population.

A cross-sectional study was conducted at a third level Mexican rheumatology centre. Women of reproductive age were divided into two groups: those with RA and healthy controls. PMDD was evaluated using the Premenstrual Symptoms Screening Tool (PSST), which diagnoses PMDD based on severe affective and somatic symptoms accompanied by functional impairment. Statistical analyses included descriptive statistics and Chi-square or Fisher's exact tests for qualitative variables.

Sixty-seven participants per group, matched by age (mean: 39.8 ± 8.2 years), were included. PMDD prevalence was higher in the RA group (24%, n = 15) compared to controls (6%, n = 4) (p = 0.006; OR 4.54, 95% CI: 1.42-14.52). Although no significant differences were found in the frequency of severe affective or somatic symptoms, functional impairment due to PMDD was more common in women with RA (28.4%, n = 19) than in controls (7.5%, n = 4) (p = 0.002; OR 4.9, 95% CI: 1.70-14.0).

Women with RA have a significantly higher prevalence of PMDD and associated functional impairment compared with healthy controls. These findings suggest a greater burden of premenstrual symptoms in this population.