Bidirectional Association Between Premenstrual Disorders and Psychiatric Disorders

Area of Science:

• Psychiatry and Reproductive Health
• Epidemiology
• Clinical Psychology

Background:

• Premenstrual disorders (PMD) frequently co-occur with psychiatric conditions, yet the nature of this association is not fully understood.
• Existing research has primarily focused on major affective disorders, leaving a gap in understanding PMD's relationship with a broader spectrum of psychiatric conditions.

Purpose of the Study:

• To investigate potential bidirectional associations between premenstrual disorders (PMD) and a wide range of psychiatric disorders.
• To clarify the direction and extent of the relationship between PMD and various mental health conditions.

Main Methods:

• A Swedish nationwide cohort study utilizing register data from January 1, 2001, to December 31, 2022.
• Matched cohort and nested case-control designs were employed to assess psychiatric disorders before and after PMD diagnosis.
• Analyses included comparisons between women with PMD, their unaffected sisters, and general population controls.

Main Results:

• Women with PMD had approximately double the risk of a prior psychiatric disorder diagnosis (OR, 2.41) and were twice as likely to receive a subsequent PMD diagnosis if they had a psychiatric disorder (HR, 2.23).
• These bidirectional associations were attenuated but remained significant in sibling analyses (OR, 1.95; HR, 1.82).
• Strongest associations were observed for depression, anxiety, ADHD, bipolar disorder, and personality disorders, but not schizophrenia.

Conclusions:

• This study demonstrates significant bidirectional associations between premenstrual disorders (PMD) and a broad range of psychiatric conditions.
• The findings underscore the importance of considering menstrual cycle-related health in psychiatric care and vice versa.
• Further research is warranted to elucidate the shared underlying mechanisms connecting PMD and psychiatric disorders.