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American Study explores the possible link between PMS and PostPartum Depression
3 April 2013
Examination of premenstrual symptoms as a risk factor for depression in postpartum women.

Teri Pearlstein,
Scott Stuart,
Caron Zlotnick,
Michael W. O’Hara

Abstract
Postpartum depression (PPD) is a significant public health concern with prevalence of major and minor depressions reaching 20 % in the first three postpartum months. Sociodemographic and psychopathology correlates of PPD are well established; however, information on the relationship between premenstrual disorders and the development of PPD is less well established. Thus, the aim of this study was to examine the role of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) as a risk factor for PPD.

Premenstrual symptoms were assessed retrospectively using the premenstrual symptoms screening tool (PSST) and depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and assessed using Hamilton Depression Rating Scale (HDRS)

A two-stage screening procedure was applied. In the first stage, the Patient Health Questionnaire (PHQ-9) was employed. In the second stage, women endorsing >= 5 symptoms on the PHQ-9 were administered the Structured Clinical Interview for DSM-IV, HDRS, and PSST.

Hierarchical linear regression showed that history of depression and PMS/PMDD contributed an additional 2 % of the variance (p < 0.001), beyond that of sociodemographic factor effects. The full model accounted for 13 % of the variance in postpartum depressive symptoms. Using logistic regression, a significant association also emerged between PMS/PMDD and PPD (OR = 1.97).

The findings of this study suggest that PMS/PMDD is an important risk factor for PPD. Women endorsing a history of PMS/PMDD should be monitored during the perinatal period.

 


New Concessionary rate for Professional membership
4 April 2013
Trainees to benefit
A new concessionary rate of subscription is being introduced for Health Professional Trainees. The following will be entitled to join at this new rate.
 

Trainee nurses, trainee GPs, sub consultant gynaecologists and all other health professionals in training grades.

A year’s subscription will cost £35 and will provide access to all standard membership benefits plus receipt of the NAPS Guidelines on PMS and its treatment as well as free attendance at NAPS Study Days.

We hope that this will be an incentive for those who are embarking on careers that will impact on the health of women and that of sufferers of PMS in particular, to improve the wellbeing of those who will seek their expertise and help.

Details of how to access this concession are to be found on how to join NAPS.
































































































































































































 
NAPS Study Day on Women's Health, Southampton, 1st March 2013
13 March 2013
Report by Cat Hawkins

Living near the venue, Cat Hawkins, whose campaigning work on getting extreme PMS/PMDD properly recognised, is publicly acknowledged by NAPS, was invited to report on The NAPS Study Day in Southampton for the bulletin.

I was invited  to the recent NAPS Study day on Women's Health in Southampton. As a PMS Lay Champion, PMDD sufferer and Health Activist I was permitted to attend the event which is usually only for medical professionals and trainee's. It was an amazing opportunity for me to get a window into what goes on behind the scenes and a perfect opportunity to share with others and let them know what happens at these things! Thankfully, I was in the ovulatory phase of my cycle, and so was able to attend. Had the conference been held a week later, I may not have made it!

The venue (The Hub Theatre in Southampton College) was very good. Bright, clean and welcoming. It was really lovely to meet Jackie, the CEO of NAPS, as we had spoken via email quite a few times. I was a bit nervous, but after a coffee and a chat with Jackie, It felt good to be there.

Talks  began with Mr Nick Panay, Consultant Gynaecologist and the Chairman of NAPS. After an introduction to the day and NAPS, he went on to talk us all through the NAPS guidelines on the management of PMS. They provide a very useful tool for GP's and patients when devising plans for managing PMS. Mr Panay touched on the history of PMS, quoting Hippocrates and that the first time anyone made any connections between PMS and cyclical ovarian activity was Henry Maudsley in 1873  In the 19th century many called it 'Menstrual madness' and believed it was brought on by women reading serious books or playing music! By 1931 the term Premenstrual Tension was coined and in 1953, Dalton and Greene introduced the term  Premenstrual Syndrome. In 1957 Katharina Dalton set up the first ever PMS clinic. The National Association of Premenstrual Syndrome was founded in 1983 and 5 years later,  Studd proposed that menstruation was not an essential feature of PMS and began to use the term Ovarian Cycle Syndrome. Despite the recognition in the medical profession, the stereotypes, myths and taboos that surround menstruation continue to this day, with negative articles in women's magazines still being published.

Mr Panay's talk was followed by Dr Carrie Sadler (GP and Associate Specialist in Reproductive health) and Ms Annie Hawkins (Locum Consultant  in O+G at Chelsea and Westminster Hospital) who shared results taken from the Southampton Women's Survey and the NAPS Survey 2011. The Southampton Women's Survey started in the 1990's and interviewed over 12 000 non pregnant women and included questions about PMS. The survey also followed these women through pregnancy and the development of their children. The most interesting conclusion was that women were less likely to have symptoms if they had been educated about the effects of the menstrual cycle and how to manage their symptoms. It was also noted that stress was a major factor in the severity of symptoms. Both surveys showed the need for more research and funding for raising awareness.

Next was Dr Alain Gregoire, (Consultant Psychiatrist at Southampton) talking about giving good ante-natal and post natal care. Dr Gregoire was an entertaining animated speaker who introduced a variety of facts regarding the research done on the effects of depression in pregnancy and how it can affect the child later on in life. He also noted that despite the research proving that mothers pre disposed to depression were highly likely to have problems post natally, that very little was in place to support these mothers.

Ms Dani Singer, Adult Psychotherapist, London, spoke about the psychological aspects of premature ovarian sufficiency and highlighted the need for sensitive labelling of such disorders. Using words such as failure or dysfunction can create a negative reaction in the patient and lead to a misunderstanding of the problem itself. Labels are not always helpful to the condition.

Diet and the Menstrual Cycle was the topic presented by Ms Amanda Moore, Nutritionist, London. This talk highlighted the benefits of a healthy, low GI diet and its positive effects on premenstrual symptoms.  Nutrition plans can be devised depending on the symptoms presented. If there are more physical problems, foods to help support those bodily functions may help relieve symptoms, if it's more psychological, then foods can be prescribed to help with brain health and function.

The debate of the day should have been between Professor John Studd (Professor of Gynaecology, London PMS and Menopause Centre) and Ms Claudine Domoney (Consultant O+G, Chelsea and Westminster Hospital). The topic - HRT can be taken forever. Unfortunately, Professor Studd was indisposed so Claudine ably and entertainingly presented both sides of the debate with an occasional comment from Mr Panay It was concluded that the newer bio-identical forms of HRT are safe for continuous use as they work in very small doses, and if an individual is happy with their medication there is no real reason to stop.

After a brief break for lunch, it was back into the theatre for a discussion on contraception with Gilly Andrews, Clinical Nurse Specialist, London. It was amazing to hear about the advances in the contraceptive pill and the different types of pill coming onto the market. It was also explained that the reasons certain brands of pill are available abroad but not in the UK  are because the UK health authorities refuse to allow them to be prescribed. This is often on account of cost, or concerns over safety.

The afternoon begin with Ms Claudine Domoney and Ms Annie Hawkins looking  at sexual problems in women and how to diagnose correctly by taking into account other factors such as stress and background.

Mr Tim Hillard, Consultant Obstetrician and Gynaecologist from Poole Hospital discussed pelvic floor disorders and the best way to help patients, including some really effective methods of treatment

Mr Michael Dooley, Consultant Gynaecologist and Medical Director from The Poundbury Clinic talked about fertility and the menopause, including what effects fertility and ways of dealing with infertility.

Thank you to NAPS for letting me peep through the window into the medical world, for supporting my work so far and asking me to report on the study day

By Cat Hawkins

To read Cat's personal response to the day goto www.meetmypmdd.blogspot.co.uk

 










Postpartum depression (PPD) is a significant public health concern with prevalence of major and minor depressions reaching 20 % in the first three postpartum months. Sociodemographic and psychopathology correlates of PPD are well established; however, information on the relationship between premenstrual disorders and the development of PPD is less well established. Thus, the aim of this study was to examine the role of premenstrual syndrome (PMS)/premenstrual dysphoric disorder (PMDD) as a risk factor for PPD.

Premenstrual symptoms were assessed retrospectively using the premenstrual symptoms screening tool (PSST) and depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and assessed using Hamilton Depression Rating Scale (HDRS)

A two-stage screening procedure was applied. In the first stage, the Patient Health Questionnaire (PHQ-9) was employed. In the second stage, women endorsing >= 5 symptoms on the PHQ-9 were administered the Structured Clinical Interview for DSM-IV, HDRS, and PSST.

Hierarchical linear regression showed that history of depression and PMS/PMDD contributed an additional 2 % of the variance (p < 0.001), beyond that of sociodemographic factor effects. The full model accounted for 13 % of the variance in postpartum depressive symptoms. Using logistic regression, a significant association also emerged between PMS/PMDD and PPD (OR = 1.97).

The findings of this study suggest that PMS/PMDD is an important risk factor for PPD. Women endorsing a history of PMS/PMDD should be monitored during the perinatal period.


New Concessionary rate for Professional membership
4 April 2013
Trainees to benefit
A new concessionary rate of subscription is being introduced for Health Professional Trainees. The following will be entitled to join at this new rate.
Trainee nurses, trainee GPs, sub consultant gynaecologists and all other health professionals in training grades.

A year’s subscription will cost £35 and will provide access to all standard membership benefits plus receipt of the NAPS Guidelines on PMS and its treatment as well as free attendance at NAPS Study Days.
We hope that this will be an incentive for those who are embarking on careers that will impact on the health of women and that of sufferers of PMS in particular, to improve the wellbeing of those who will seek their expertise and help.

Details of how to access this concession are to be found on how to join NAPS.

 
NAPS Study Day on Women's Health, Southampton, 1st March 2013
13 March 2013
Report by Cat Hawkins

Living near the venue, Cat Hawkins, whose campaigning work on getting extreme PMS/PMDD properly recognised, is publicly acknowledged by NAPS, was invited to report on The NAPS Study Day in Southampton for the bulletin.

I was invited  to the recent NAPS Study day on Women's Health in Southampton. As a PMS Lay Champion, PMDD sufferer and Health Activist I was permitted to attend the event which is usually only for medical professionals and trainee's. It was an amazing opportunity for me to get a window into what goes on behind the scenes and a perfect opportunity to share with others and let them know what happens at these things! Thankfully, I was in the ovulatory phase of my cycle, and so was able to attend. Had the conference been held a week later, I may not have made it!

The venue (The Hub Theatre in Southampton College) was very good. Bright, clean and welcoming. It was really lovely to meet Jackie, the CEO of NAPS, as we had spoken via email quite a few times. I was a bit nervous, but after a coffee and a chat with Jackie, It felt good to be there.

Talks  began with Mr Nick Panay, Consultant Gynaecologist and the Chairman of NAPS. After an introduction to the day and NAPS, he went on to talk us all through the NAPS guidelines on the management of PMS. They provide a very useful tool for GP's and patients when devising plans for managing PMS. Mr Panay touched on the history of PMS, quoting Hippocrates and that the first time anyone made any connections between PMS and cyclical ovarian activity was Henry Maudsley in 1873  In the 19th century many called it 'Menstrual madness' and believed it was brought on by women reading serious books or playing music! By 1931 the term Premenstrual Tension was coined and in 1953, Dalton and Greene introduced the term  Premenstrual Syndrome. In 1957 Katharina Dalton set up the first ever PMS clinic. The National Association of Premenstrual Syndrome was founded in 1983 and 5 years later,  Studd proposed that menstruation was not an essential feature of PMS and began to use the term Ovarian Cycle Syndrome. Despite the recognition in the medical profession, the stereotypes, myths and taboos that surround menstruation continue to this day, with negative articles in women's magazines still being published.

Mr Panay's talk was followed by Dr Carrie Sadler (GP and Associate Specialist in Reproductive health) and Ms Annie Hawkins (Locum Consultant  in O+G at Chelsea and Westminster Hospital) who shared results taken from the Southampton Women's Survey and the NAPS Survey 2011. The Southampton Women's Survey started in the 1990's and interviewed over 12 000 non pregnant women and included questions about PMS. The survey also followed these women through pregnancy and the development of their children. The most interesting conclusion was that women were less likely to have symptoms if they had been educated about the effects of the menstrual cycle and how to manage their symptoms. It was also noted that stress was a major factor in the severity of symptoms. Both surveys showed the need for more research and funding for raising awareness.

Next was Dr Alain Gregoire, (Consultant Psychiatrist at Southampton) talking about giving good ante-natal and post natal care. Dr Gregoire was an entertaining animated speaker who introduced a variety of facts regarding the research done on the effects of depression in pregnancy and how it can affect the child later on in life. He also noted that despite the research proving that mothers pre disposed to depression were highly likely to have problems post natally, that very little was in place to support these mothers.

Ms Dani Singer, Adult Psychotherapist, London, spoke about the psychological aspects of premature ovarian sufficiency and highlighted the need for sensitive labelling of such disorders. Using words such as failure or dysfunction can create a negative reaction in the patient and lead to a misunderstanding of the problem itself. Labels are not always helpful to the condition.

Diet and the Menstrual Cycle was the topic presented by Ms Amanda Moore, Nutritionist, London. This talk highlighted the benefits of a healthy, low GI diet and its positive effects on premenstrual symptoms.  Nutrition plans can be devised depending on the symptoms presented. If there are more physical problems, foods to help support those bodily functions may help relieve symptoms, if it's more psychological, then foods can be prescribed to help with brain health and function.

The debate of the day should have been between Professor John Studd (Professor of Gynaecology, London PMS and Menopause Centre) and Ms Claudine Domoney (Consultant O+G, Chelsea and Westminster Hospital). The topic - HRT can be taken forever. Unfortunately, Professor Studd was indisposed so Claudine ably and entertainingly presented both sides of the debate with an occasional comment from Mr Panay It was concluded that the newer bio-identical forms of HRT are safe for continuous use as they work in very small doses, and if an individual is happy with their medication there is no real reason to stop.

After a brief break for lunch, it was back into the theatre for a discussion on contraception with Gilly Andrews, Clinical Nurse Specialist, London. It was amazing to hear about the advances in the contraceptive pill and the different types of pill coming onto the market. It was also explained that the reasons certain brands of pill are available abroad but not in the UK  are because the UK health authorities refuse to allow them to be prescribed. This is often on account of cost, or concerns over safety.

The afternoon begin with Ms Claudine Domoney and Ms Annie Hawkins looking  at sexual problems in women and how to diagnose correctly by taking into account other factors such as stress and background.

Mr Tim Hillard, Consultant Obstetrician and Gynaecologist from Poole Hospital discussed pelvic floor disorders and the best way to help patients, including some really effective methods of treatment

Mr Michael Dooley, Consultant Gynaecologist and Medical Director from The Poundbury Clinic talked about fertility and the menopause, including what effects fertility and ways of dealing with infertility.

Thank you to NAPS for letting me peep through the window into the medical world, for supporting my work so far and asking me to report on the study day

By Cat Hawkins

To read Cat's personal response to the day goto www.meetmypmdd.blogspot.co.uk