Core symptoms and profiles in premenstrual syndrome

描述（由申请人提供）：这是我们对经前综合征（PMS）研究的竞争性延续。经前综合症是一种复杂的慢性疾病，包括与女性月经周期有关的情绪、行为和身体症状，每个月都会有几天到两周的时间扰乱身体机能。本应用程序的具体目的是利用在NIH研究中寻求经前症候群治疗的妇女的现有数据来确定以下内容：1)确定临床显著经前症候群的5-7个核心症状及其与功能障碍的关联；2)识别严重经前综合症女性的症状特征（群集）。3)检验5 -羟色胺能抗抑郁药治疗是否有差异反应；比较与症状相关的改善与与核心症状相关的改善，以确定症状是否比Aim 1中确定的核心症状更有临床意义。4)比较非裔美国人和白种人妇女经前症候群的症状和症状特征。虽然大约20%的经期妇女遭受经前症候群的折磨，其程度严重折磨并扰乱了她们的日常功能，但经前症候群的诊断尚无明确且被广泛接受的标准。虽然经前烦躁不安（PMDD）的效用被证明用于研究目的，但其限制性标准未能包括临床环境中的大多数病例。对经前症候群缺乏广泛接受的诊断会造成巨大的经济成本，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证明。从她们在生育期内的疾病负担来看，个人费用也很高。确定经前症候群的核心症状和显著导致经前症候群受损的症状，有助于对这种疾病进行更循证和被广泛接受的诊断。识别对SSRI治疗有反应的症状和/或症状概况可以改善对更可能有反应的症状的使用这种治疗。经前症候群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研究中选择的女性症状的异质性，从而使研究结果更加一致，并增加识别该疾病潜在机制的可能性。这项研究的结果对初级保健尤其重要，在初级保健中，对过多的症状进行评估很少或可行，并且没有系统的方法来确定病例。进一步的资料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.