• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.198-206
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• 1996

To assess premenstrual changes in adolescents, a self rating retrospective premenstrual assessment from(PAF) and a prospective daily rating form(DRF) were administered to 230 high school students who reported premenstrual changes. The results were as follows 1) According to typological categories of retrospective premenstrual assessment form, the most commonly reported changes in mood and behavior were major depressive syndrome(40.0%), impulsive syndrome(20.9%). Especially among the subtype of depressive syndrome, hostility feature and withdrawal feature were most frequent. The most commonly reported changes in physical condition were general discomfort(73.5%), fatigue(33.9%). 50.9% of all subjects reported impaired social function. 2) 41.2% of the subjects who met the criteria for typological categories of retrospective premenstrual assessment form were confirmed by prospective daily rating form. 3) According to different criteria of percent change method of assessing symptom change, 38.7% of all subjects had at least one mild premenstrual change and 23.5% had at least one moderate premenstrual change. 4) Using prospective daily rating form, overall psychological changes were confirmed more frequently than physical changes. Of the mild premenstrual changes, 'low energy, tired & weak', 'less or impaired work' were most common changes. Of the moderate premenstrual changes, the most common change was 'low energy, tired & weak'. 5) As attitude toward menstruation, 44.9% of the subjects with confirmed premenstrual changes had more negative attitude(disgusted) toward menstruation. 6) The subjects with confirmed mild or moderate premenstrual changes had only dysphoric mood changes or both physical and dysphoric mood changes, but did not have only physical changes. These results suggest that retrospective reports of premenstrual changes were partially confirmed by daily prospective ratings. A substantial number of adolescents appeared to experience premenstrual changes, and the most common confimed premenstrual change of mild or moderate severity was 'low energy, tired and weak'.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.103-115
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• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.21-36
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• 1996

This study was attempted to investigate reliability and validity of premenstrual assessment form(PAF). PAF was administered to 230 high school students who had reported premenstrual changes. PAF revealed considerable diversity in premenstrual symtom changes of the subjects. The items with most frequent reported premenstrual changes were 21 items out of 95. Cronbach's internal consistency was .95, and test-retest reliability was .80. Validity test was performed by constructional validation analysis. 8 factors(impulsive & unstable factor, depressive factor, withdrawal & social functioning impairment factor, anxiety & cognitive dysfunction factor, physiological factor, general discomfort factor, increased well-being factor, other factor) emerged at factor analysis. Each of them accounted for 33.97, 5.10, 3.70, 2.93, 2.64, 2.46, 2.12, 2.03 of total variance respectively. High school students experienced impulsive & unstable features of premenstrual symptoms more frequently. This study suggests PAF can be a reliable and valid tool as a initial screening and evaluation of premenstrual changes. finally, factor analysis result was compared with PAF typological categories.

• 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.

• Korean Journal of Adult Nursing
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• v.14 no.1
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• pp.144-153
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• 2002

Purpose: The purpose of this study was to describe the premenstrual syndrome and the relationships among premenstrual syndrome, automatic thought, and perfectionism. Methods: The 164 subjects were selected from a nursing college in Tae-Jeon. The data were collected using the PAF, ATQ-N, and MPS from April 10th to May 10th, 2001. Results: The results of this study were as follows : 1. There was no significant difference in premenstrual syndrome due to menarche, duration of menstruation, and menstrual cycle, but significant difference in premenstrual syndrome due to amount of menstruation and regularity of menstrual cycle. 2. The subjects experienced mild premenstrual syndrome. The severe premenstrual syndromes above the mean were who subjects reported general physical discomfort, fatigue, low mood and loss of pleasure, lability and atypical depressive features, et. al., and those below the mean experienced hostility/anger, increased well-being, miscellaneous mood/behavior change, impulsive syndrome and miscellaneous physical changes, et. al. 3. The score of mean premenstrual syndrome was 236.55, that of automatic thought was 31.41 and that of perfectionism was 185.97. The premenstrual syndrome score was similar to those of other studies and subjects had low automatic thought and moderate perfectionism. 4. There were significant correlations among premenstrual syndrome, automatic thought, and perfectionism (P <. 001). 5. Automatic thought and perfectionism accounted for 17 percent of premenstrual syndrome. Conclusions: For future research, it was recommended that the study to identify major factors affecting premenstrual syndrome and the relationships between them with various subjects should be done and effective nursing intervention for premenstrual syndrome should be developed.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.1
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• pp.29-35
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• 2012

Purpose : The purpose of this study was to investigate effect of the lumbo-pelvic stabilization exercise on relief of menstrual pain and premenstrual syndrome of the female university students. Methods : Thirty female students with dysmenorrhea were participated in this study. Subjects divided into experimental group(n=15) and control group(n=15). Experimental group were given lumbo-pelvic stabilization exercise and control group didn't have any application to exercise. Menstrual pain measured by VAS(Visual Analogue Scale) and premenstrual syndrome measured by MDQ(Moos Menstrual Distress Questionnaire) scale. Results : The experimental group were significantly improved menstrual pain and symptoms of premenstrual syndrome, but negligible changes were found in the control group. Conclusion : This study show that lumbo-pelvic stabilization exercise is beneficial intervention for decrease menstrual pain and premenstrual syndrome.

• Journal of Korean Academy of Nursing
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• v.18 no.1
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• pp.80-93
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• 1988

This study was planned and carried out to investigate the correlation between premenstrual syndrome and personality in order to provide informations basic to the prevention, alleviation, and care for the premenstrual syndrome. Data on premenstrual syndrome were gatherd from October 20 to 25, 1986 by questionnaire modified by the researcher based on Endicott's Premenstrual Assessment Form. Reliability of the instrument was tested by Cronbach's $\alpha$. Data on personality were gathered in March, 1986, by the high school autorities by standardized Personality Inventory Scale developed by Eung Yun Hwang were used. Subjects numbered 457, 95.2% of the first grade students of H. Girls High School located in Seoul. The correlation and difference between personality traits and premenstrual syndrome analysed by Pearson's Correlation Coefficient, and difference between groups were analysed by the t-test. Personality traits influencing premenstrual syndromal categories were analysed by the multiple regression. The results are as follows : I. The five highist categories of premenstrual syndrome among 18 categories revealed to be Social withdrawal, General discomfort, Lability, Fatigue and Hostility / Anger in rank order. II. Personality traits and Premenstrual syndrome ; 1. Tendency of Psychoneuroses(r＝0.43, p＜.001), psychoses(r＝.39, p＜.001) and anti-social behaviors (r＝0.43, p＜.001) revealed to be significantly correlated to premenstrual syndrome. Hypothesis 1 is accepted. 2. Emotional stability(r＝ -0.38, p＜.001), reflectiveness (r＝ -0.14, p＜.01), masculinity (r＝ -0.10, p＜05) and antonomy (r＝ -0.12, p＜.05) revealed significant correlation, While activity, dominance, sociability and achivement revealed no significant correlation. Hypothesis 2 is partially accepted. III. Significant models of personality traits influencing the premenstrual syndromal categories are ; 1. 5 personality traits : tendency of psychoneuroses, emotional stability, dominance, activity and autonomy revealed to influence Low mood / loss of pleasure significantly. ($R^2$＝.19) 2. 3 personality traits ; tendency of psychoneuroses, emotional stability and sociability revealed to influence Lability significantly. ($R^2$＝.15) 3. 5 personality traits ; tendency of psychoneuroses, activity, emotional stability, sociability and achievement revealed to influence Anxiety significantly.($R^2$＝.18) 4. 3 personality traits : tendency of psychoneuroses, emotional stability and sociability revealed to influence Miscellaneous mood / behavior changes significantly.($R^2$＝.18) 5. 3 personality traits : tendency of psychoneuroses, psychoses and reflectiveness revealed to influence Hysteroid features significantly.($R^2$＝.16) IV. No significant correlation between irregularity of menstruation and premenstrual syndrome was revealed. No significant difference between group of dysmenorrhea and group of non-dysmenorrhea in premenstrual syndrome was revealed.

• Korean Journal of Psychosomatic Medicine
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• v.3 no.2
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• pp.115-125
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• 1995

Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.