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Background: Recently, there has been increased interest in the ability of female reproductive hormones to impact psychoneurological processes involving the interplay of several body systems. This lends reliability to the view of premenstrual dysphoric disorder (PMDD) as a disorder founded in real biochemical disturbances (1,2). Although the effects of the menstrual cycle on emotional state and cognitive function have been only recently systematically studied, they have long been recognized. Previously published studies yielded inconsistent data in terms of cognitive tests throughout the cycle phases (1, 3, 4).
Objective: This study aimed to compare the effects of cyclic reproductive hormonal changes on cognitive, emotional, and behavioral function in childbearing age female patients with generalized anxiety disorder (GAD) and those with premenstrual dysphoric disorder (PMDD).
Method: One of psychiatric samples was a group of PMDD (n = 42), and the other was a group of GAD patients (n = 36), who had 20 and higher on the Hamilton Anxiety Scale (HAM-A) score. An age matched healthy control group (n = 40) was also included in the study. The psychiatric rating scales were applied twice according to the menstrual phases. The frontal assessment battery, Stroop test, and Weschler verbal memory tests were applied for the evaluation of neurocognitive changes with respect to follicular and late luteal phases.
Results: There was a significant increase in dysphoric mood during the luteal phase in women with PMDD compared to their follicular phase and compared to the GAD women and the control group. Taken together with the repeated measures and the data analysis, the GAD group had significantly worse performance regarding overall neurocognitive functions in their luteal phase (particularly memory skills, attention, and psychomotor function) as compared to the PMDD group, whereas the control group had significantly better performance overall.
Conclusions: Even though neurocognitive impairments seen in the women with PMDD were partly due to the dysphoric mood during the late luteal phase, it seems to be related to the physiological and psychoneurological processes in which female reproductive hormones may have a central role.
References:
1. Farage MA, Osborn Thomas W, MacLean AB. Cognitive, sensory, and emotional changes associated with menstrual cycle: a review. Arch Gynecol Obstet. 2008; 278: 299- 307.
2. Reed SC, Levin FR, Evans SM. Changes in mood, cognitive performance and appetite in the late luteal and follicular phases of the menstrual cycle in women with and without PMDD (Premenstrual Dysphoric Disorder). Horm Behav. 2008; 54: 185- 193.
3. Morgan M, Rapkin A. Cognitive flexibility, reaction time, and attention in women with premenstrual dysphoric disorder. J Gend Specif Med. 2002; 5: 28- 36.
4. Morgan M, Rapkin AJ, D’Elia L, Reading A, Goldman L. Cognitive functioning in premenstrual syndrome. Obstet Gynecol. 1996; 88: 961- 966.
5. Resnick A, Perry W, Parry B, Mostofi N, Udell C. Neuropsychological performance across the menstrual cycle in women with and without premenstrual dysphoric disorder. Psychiatry Research 1998; 77:147- 158.