Core symptoms and profiles in premenstrual syndrome

描述（由申请人提供）：这是我们经前综合征（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，每个月会中断几天到两周的功能。本申请的具体目的是利用在我们的NIH研究中寻求PMS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PMS的5-7个核心症状的子集及其与功能障碍的相关性; 2）确定重度PMS女性的症状特征（簇）。3)检测这些特征是否对阿托伐他汀能抗抑郁药治疗有差异反应;比较症状特征相关的改善与核心症状相关的改善，以确定症状特征是否比目标1中确定的核心症状更有临床意义。4)比较非洲裔美国人和白人妇女的经前综合症症状和症状特征。虽然大约20%的女性患有PMS，其程度严重令人痛苦并扰乱日常功能，但目前还没有被证明和广泛接受的PMS诊断标准。虽然经前焦虑障碍（PMDD）的效用是出于研究目的，但其限制性标准未能包括临床环境中的大多数病例。缺乏广泛接受的经前综合征诊断具有重大的经济成本，这是由于诊断不佳和治疗不充分造成的，这些妇女的医疗保健服务费用增加就是明证。在她们的生育期内，疾病的负担也表明个人的代价很高。识别PMS的核心症状和显著导致PMS损害的症状有助于对这种疾病进行更循证和广泛接受的诊断。识别对SSRI治疗有反应的症状和/或症状谱可以改善这种治疗对更有可能反应的症状的使用。PMS症状是否存在种族差异尚不清楚，但对医疗保健很重要。这项研究的信息还可以减少被选入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，并增加了识别该疾病潜在机制的可能性。这项研究的结果对于初级保健特别重要，因为对过多症状的评估很少进行或可行，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保健。

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.