• Korean Journal of Psychosomatic Medicine
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• v.15 no.1
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• pp.14-21
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• 2007

Premenstural dysphoric disorder(PMDD) imposing 4-5% of women is possibly caused by an enhanced responsiveness to the changes of sex steroid hormones and the decrease of serotonin, melatonin and GABA. The common clinical features between PMDD and depression, seasonal affective disorder, panic disorder and anorexia nervosa suggest a relatedness between PMDD and each of them. The diagnostic criteria of DSM-IV-Tr for PMDD requires psychological symptoms, that commonly include irritability, anger, depression, mood swing, affect lability, tension, anxiety, fatigue and food craving. As of today, the best pharmacological treatment for PMDD is the selective serotonin reuptake inhibiter, and leuprolide, danazol, estradiol, spironolactone and bromocriptine are possible alternatives. Nonpharmacological treatments for patients with mild to moderate symptom severity are diet, exercise, light therapy, psychotherapy and keeping a diary.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.39-46
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• 2006

Objectives: The study was intended to explore the relationships between temperament and premenstrual dysphoric disorder, to understand symptomatology of premenstrual dysphoric disorder and associated personality trait and to suggest therapeutic availability. Method : Twenty eight women, diagnosed as premenstrual dysphoric disorder by DSM-IV, were asked to complete the Korean version of Tridimensional Personality Questionnaire, and Shortened Premenstrual Assessment Form. The correlations between the severity of premenstrual symptoms and the scores of Tridimensional Personality Questionnaire were calculated. Results : The severity of symptoms of premenstrual dysphoric disorder was best explained by the harm-avoidance factor of the four dimensions of temperament. Conclusion : The symptoms of premenstrual dysphoric disorder are well explained by the harmavoidance factor and the reward-dependence factor of four dimensions of the temperament.

• Journal of Nutrition and Health
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• v.35 no.3
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• pp.314-321
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• 2002

Women with the premenstrual dysphoric disorder (PMDD) report increased cravings for certain foods and altered taste preferences ding the premenstrual period. The objective of the present study was to investigate the association of PMDD with luteal phase food cravings, appetite, and taste preferences in 1,078 nurses. Among the 626 nurses who gave valid responses, the prevalence of PMDD and premenstrual syndrome (PMS) was 4.6% (N = 29) and 78.3% (N = 490), respectively. A highly significant increase was observed in the preference for sweet tasting foods during the luteal phase, compared to the follicular phase. Desire for sweet foods during the premenstrual period was significantly different among the three groups, being highest in the PMDD group, lower in the PMS group, and lowest in women with no symptoms. Both the PMDD and PMS groups showed significant increases in preferences for pungent tasting foods during the luteal phase. A repeated measures of analysis of variance on the taste preference data revealed that the desire for sweet tasting foods was significantly greater than for others such as salty, sour, and pungent tastes. A greater proportion of the subjects in the PMDD and PMS groups reported an increase in their total food intake during the luteal phase, compared to those women without premenstrual symptoms. Compared to the PMS group or the women with no symptoms, the PMDD group reported increased intakes of high carbohydrate foods during the luteal phase. The most commonly reported food cravings were for sauteed spicy rice cakes (ddukbokki), or for cold buckwheat noodles mixed in chili pepper sauce. These results indicate that the luteal phase food cravings, appetite and taste preferences change in accordance with the severity of the premenstrual symptoms.

• Sleep Medicine and Psychophysiology
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• v.6 no.1
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• pp.46-51
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• 1999

Objectives: Patients with premenstrual dysphoric disorder(or PMDD) have impairments of the social, occupational or academic function due to psychological or somatic symptoms, which have the characteristic pattern of symptom exacerbation in the week before menses begin and remission shortly after the onset of menses. In the chronobiological view, many researchers have assumed that the etiology of PMDD is the advanced circadian rhythm. It has been suggested that light has a therapeutic effect on PMDD, because evening light results in phase delay of circadian rhythm through the biochemical changes including melatonin. Methods: The authors investigated the therapeutic effect of light therapy on four patients with prospectively diagnosed PMDD by DSM-IV criteria using clinical psychiatric interview, Premenstrual Assessment Form(PAF) and Daily Rating Form(or DRF). In the evening(6:30pm-8:00pm), the 2,500 lux light administered for seven consecutive days during the symptomatic late luteal phase of menstrual cycle. Beck Depression Inventory(or BDI), Hamilton Rating Scale for Depression(or HAM-D), Spielberg State Anxiety Inventory(or SA), and DRF were evaluated before and after seven days of light therapy. Results: Premenstrual symptoms of PMDD could be effectively treated with the evening bright light therapy, especially in PMDD patients with atypical symptoms. In addition, the light therapy seemed to more effective on the psychologic symptoms than the somatic symptoms of PMDD. There was no significant side-effect of light therapy, except the transient and mild eye-strain in one case. Conclusions: In spite of the results of limited data from our clinical trial, the authors suggest that the potential use of light therapy as an alternative to the pharmacological management of patients with PMDD.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.57-65
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• 2015

Objectives:Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. Methods:This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. Results:A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). Conclusions:This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.2
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• pp.190-195
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• 2005

The purpose of this study was to identify the change of energy intake, blood sugar and body composition in accordance with menstrual cycle among the women with the premenstrual dysphoric disorder (PMDD) group and women with no premenstrual symptoms (NPS) group. Energy and carbohydrate intake were significantly increased in luteal and menstrual phases than follicular phase in both groups. Protein intake was significantly increased in luteal phase than follicular phase in both of groups. Fat intake was not difference in according to the menstrual phases in both groups. Weight and body water were significantly increased in luteal and menstrual phases than follicular phase in both groups. Fat mass was significantly increased in luteal phase than follicular phase in both groups. However, the differences in energy, carbohydrate, protein and fat intake, weight, body water and fat mass between groups were not significant. Above finding of this study showed that women's energy intake and body composition have connection with change of menstrual cycle and implied that more systematic study which affects menstrual cycle is requested.

• Korean Journal of Psychosomatic Medicine
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• v.5 no.1
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• pp.52-62
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• 1997

This study was designed to determine the frequency of premenstrual dysphoric disorder in gynecological outpatients, and also attempted to compare premenstrual change characteristics, functional impairment due to premenstrual changes and frequency of risk factors reported by women with confirmed premenstrual changes$(PMC^+)$(n=17) and those without confirmed premenstrual changes$(PMC^-)$(n=23). Forty gynecological outpatients who complained of premenstrual discomforts were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and premenstrual change and functional impairment. The women were also asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle. Absolute severity method, effect size method and percent change method were used to assess changes between follicular phase and luteal phase. The results of the study were as follows: 1) The frequency of premenstrual dysphoric disorder according to each of the three methods was 5% for the absolute severity method, 15% for the effect size method, and 27.5% for the percent change method. 2) The frequently reported symptoms were as follow: physical symptoms(64.7%) : lethargy, easy fatigability, or marked lack of energy(41.2%) : decreased interest in usual activities(29.4%) ; and marked affective lability(23.5%). 3) There were no significant differences in onset ages of premenstrual changes, regularities of premenstrual changes and changes of severity and duration of premenstrual symptoms over time between women with and without confirmed premenstrual changes. However, women with confirmed premenstrual changes reported both physical and emotional symptoms as earliest symptoms most frequently, while women without confirmed premenstrual changes reported only physical symptoms most frequently. 4) functional impairment was significantly higher in women with confirmed premenstrual changes than those without confirmed premenstrual changes, but impairment was not severe. 5) No differences were found between women with and without confirmed premenstrual changes in risk factors including demographic data, menstrual and obstetric and gynecological history. These results suggest that the prevalence of premenstrual dysphoric disorder varies with scoring methods. The women with confirmed premenstrual changes reported physical symptoms most frequently(64.7%). functional impairment was significantly higher in women with confirmed premenstrual changes, but impairment was not severe.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.1
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• pp.52-60
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• 1996

Premenstrual symptoms can begin at anytime after menache and usually remit with menopause. Numerous studies of the premenstrual symptoms have been reported, based on mature woman and clinic patients. As yet, however, no prospective study has specially examined the extent or nature of PMS in adolescents. The authors investigated the pattern of mood, behavior and physical symptom changes in the menstrual cycle for 230 high school students who reported premenstrual symptoms by using Baily Rating form(DRF), The scores on 21 symptoms of DRF were recorded daily for at least one menstrual cycle. The results as follows : 1) 1.7%(4/230) of the subjects who reported premenstrual symptoms met criteria for premenstrual dysphoric disorder(PMDD) by 30% change criteria. 2) The pattern of symptom changes in the menstrual cycle showed a clear increase in mean daily symptom score at premenstrual -1,-2 day. and reaching a maximum scores at the first day, rapidly decreased at day 4 during menstruation. 3) The mean daily symptom score in the menstrual phase was significantly higher than those in the premenstrual and postmenstrual phase, and significantly higher in the premenstrual phase than that in postmenstrual phase. 4) The scores of the subjects with longer duration of menstrual bleeding were higher than those of the subjects with the shorter duration. Particularly in the menstrual phase, there was a significant difference on the mean scores of physical symptom duster between the longer and shorter group. These results demonstrated that the mean daily pattern of symptom changes in the menstrual cycle for the subjects was similar pattern of change for the PMDD group, except high level of symptom scores if premenstrual phase. The adolescents might experienced more physical discomfort than the other symptoms in the menstrual phase Especially the subject with longer duration of mense flow were more likely to report more discomfort than that of shorter duration.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.61-71
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• 1999

Objective : The purpose of this study was to assess the relationship between the premenstrual changes and stress perception in women with premenstrual changes($PMC^+$)(n=32) and those without premenstrual changes($PMC^-$)(n=62) by using prospective method. Method : The women who were older than 30 years of age and healthy were asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle to assess the changes of psychological and physical symptoms across the menstrual cycle. They also completed 5-point likert scale to assess the perception of stress. Percent changes method was used to assess changes between follicular phase and luteal phase. Results : 1) No significant differences were found in demographic factors(age, education, marriage, employment) and risk factors(onset ages of menarche, regularities of premenstrual changes, duration of menstruation, cycle length, amount of menstruation, dysmenorrhea) between women with and without premenstrual changes. 2) There was a significant difference in mean luteal phase stress score between women with($1.92\pm0.63$) and without premenstrual changes($1.51\pm0.42$)(p<0.05). However no difference was found in mean follicular phase stress score between two groups($PMC^+$ : $1.67\pm0.43$, $PMC^-$ : $1.33\pm0.39$). 3) We divided women having premenstrual changes into two groups, higher stress group(stress score > 1.75(median)) and the lower stress group(stress score <1.75(median)). The higher stress group reported more luteal psychological symptoms than did the lower stress group(df=1, F=13.362, p<0.001). However, the groups did not differ in physical symptoms. Conclusion : In women with premenstrual changes, luteal stress score was higher than follicular stress score and this result suggested tha the perception of stress was related to psychological symptoms but not physical symptoms. These findings suggested that premenstrual change is associated with the stress level, and that it is important to manage the stress which is focused on the management of psychological symptom in the treamtment of prementrual syndrome.