Core symptoms and profiles in premenstrual syndrome

经前综合症的核心症状和概况

• 批准号: 7319434
• 负责人: ELLEN W FREEMAN
• 金额: $ 29.93万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7319434
• 关键词: Address; Affect; African American; Aftercare; Antidepressive Agents; Anxiety; Behavioral; Caring; Caucasians; Caucasoid Race; Chronic Disease; Class; Classification; Clinical; Clinical Trials; Complex; Daily; Data; Diagnosis; Disease; Disease remission; Distress; Economics; Epidemiologic Studies; Evaluation; Gold; Health Services; Healthcare; Heterogeneity; Impairment; Investigation; Lead; Link; Measures; Medical; Menstrual cycle; Modeling; Moods; Numbers; Patients; Pattern; Pharmaceutical Preparations; Population; Premenstrual syndrome; Primary Health Care; Purpose; Race; Randomized; Range; Rate; Reporting; Research; Research Personnel; Sampling; Selective Serotonin Reuptake Inhibitor; Services; Severities; Standards of Weights and Measures; Subgroup; Symptoms; Syndrome; Techniques; Testing; United States National Institutes of Health; Week; Woman; Women' s Group; Women' s Health; base; burden of illness; clinically significant; cost; daily functioning; day; depressive symptoms; functional disability; improved; premenstrual dysphoric disorder; prognostic; programs; prospective; racial difference; reproductive; research study; response; treatment trial; trend

DESCRIPTION (provided by applicant): This is a competing continuation of our studies of premenstrual syndromes (PMS). PMS is a complex and chronic disorder that involves mood, behavioral and physical symptoms that are linked to women's menstrual cycles and disrupt functioning for several days to 2 weeks each month. The specific aims of this application are to utilize existing data from women who sought treatment for PMS in our NIH studies to determine the following: 1) Identify a subset of 5-7 core symptoms of clinically significant PMS and their associations with functional impairment; 2) Identify symptom profiles (clusters) in women with severe PMS. 3) Test whether the profiles differentially respond to serotonergic antidepressant treatment; compare the improvement associated with symptom profiles with improvement associated with core symptoms to determine whether symptom profiles are more clinically meaningful than core symptoms identified in Aim 1. 4) Compare PMS symptoms and symptom profiles between African American and Caucasian women. Although approximately 20% of menstruating women suffer from PMS to a degree that is severely distressing and disrupts daily functioning, there are no demonstrated and widely accepted criteria for a diagnosis of PMS. While the utility of premenstrual dysphoric disorder (PMDD) is demonstrated for research purposes, its restrictive criteria fail to include the majority of cases in the clinical setting. The absence of a widely-accepted diagnosis for PMS has significant economic costs that result from poor diagnosis and inadequate treatment as evidenced in the increased costs of health care services for these women. There are also high personal costs as indicated by the burden of disease over their reproductive lifetimes. Identifying core symptoms of PMS and the symptoms that significantly contribute to the impairment of PMS can contribute to a more evidence-based and widely-accepted diagnosis of this disorder. Identifying symptoms and/or symptom profiles that respond to SSRI treatment can improve the use of this treatment for symptoms that are more likely to respond. Whether there are racial differences in PMS symptoms is not known but is important for health care. Information from this study can also reduce the heterogeneity of symptoms in women selected for research studies, resulting in more consistent findings across studies and increasing the potential for identifying underlying mechanisms of the disorder. Results of the study are particularly important for primary care where evaluations of a plethora of symptoms are seldom conducted or feasible, and there is no systematic approach to identifying cases. Further information will contribute to improved health care for women in their reproductive years.

描述（由申请人提供）：这是我们经前综合症（PMS）研究的竞争性延续。经前综合症是一种复杂的慢性疾病，涉及情绪、行为和身体症状，这些症状与女性的月经周期有关，每月会扰乱几天到两周的功能。此应用程序的具体目的是利用在 NIH 研究中寻求经前综合症治疗的女性的现有数据来确定以下内容： 1) 确定具有临床意义的经前综合症的 5-7 个核心症状的子集及其与功能障碍的关联； 2) 确定患有严重经前综合症的女性的症状特征（群）。 3) 测试这些特征是否对血清素能抗抑郁药治疗有不同的反应；将与症状特征相关的改善与与核心症状相关的改善进行比较，以确定症状特征是否比目标 1 中确定的核心症状更具临床意义。 4) 比较非裔美国人和白人女性之间的 PMS 症状和症状特征。尽管大约 20% 的经期女性患有经前综合症，其严重程度令人痛苦并扰乱日常功能，但目前还没有经证实且广泛接受的经前综合症诊断标准。虽然经前焦虑症 (PMDD) 的实用性已被证明可用于研究目的，但其限制性标准未能涵盖临床环境中的大多数病例。由于缺乏广泛接受的经前综合症诊断，诊断不善和治疗不充分会造成巨大的经济成本，这些妇女的医疗保健服务成本增加就证明了这一点。生育期内的疾病负担也表明个人付出的代价也很高。识别 PMS 的核心症状以及显着导致 PMS 损害的症状有助于对该疾病进行更加循证且被广泛接受的诊断。识别对 SSRI 治疗有反应的症状和/或症状概况可以改善该治疗对更有可能有反应的症状的使用。经前综合症症状是否存在种族差异尚不清楚，但这对医疗保健很重要。这项研究的信息还可以减少选择参加研究的女性症状的异质性，从而使各项研究的结果更加一致，并增加识别该疾病潜在机制的潜力。该研究的结果对于初级保健尤其重要，因为初级保健很少对过多的症状进行评估或不可行，并且没有系统的方法来识别病例。进一步的信息将有助于改善育龄妇女的医疗保健。