Premenstrual symptoms and seasonality in women patients with bipolar disorder

  • MD Jungmi Choi, Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea, Korea
  • MA Jihae Noh, Sungkyunkwan University, Korea
  • MD Ji Hyun Baek, Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea, Korea
  • MD Ji Sun Kim, Sungkyunkwan University School of Medicine, Samsung Medical Center, Korea
  • RN-BSN Ji Sun Choi, Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea, Korea
  • MD Hee Jung Nam, Seoul Metropolitan Eunpyeong Hospital, Korea
  • MD, PhD Dongsoo Lee, Sungkyunkwan University, Korea
  • MD, PhD Kyung Sue Hong, Sungkyunkwan University School of Medicine, Korea

Objective
Recurrence of mood episodes associated with specific seasons and seasonal changes in mood and activity have been described in various mood disorders. Premenstrual symptoms are also frequently observed in mood disorder patients. This study aimed to investigate the prevalence of, and association between, cyclic behavioral changes related to season and menstruation in women patients with bipolar disorder.

Methods
Fifty-four clinically stable women bipolar patients (BP-I=26, BP-II=28) and 108 age-matched healthy women completed Seasonal Pattern Assessment Questionnaire (SPAQ) and Premenstrual symptoms screening tool (PSST). Prevalence of premenstrual dysphoric disorder (PMDD) and premenstrual syndrome (PMS) and the global severity of seasonality were retrospectively assessed on lifetime trait basis.

Results
Prevalence of PMDD and PMS was significantly higher in patient group (15% and 39%) than in control group (1% and 18%) (p=0.001 in PMDD; p=0.003 in PMS). The patient group also showed higher mean global seasonality score compared to the control group (F(1,160)=28.54, p=0.000). The global seasonality score was significantly higher in patients with PMS than in patients without PMS (F(1,52), p=0.006).

Conclusions
This study suggests that women with bipolar disorder more frequently experience premenstrual symptoms and seasonal changes in mood and behavior compared to the healthy control. The traits of these two cyclic behavioral changes seem to be associated with each other in the patient group.