Allison Kimball, Jenna Bourassa, Mark L Chicote, Anu V Gerweck, Laura E Dichtel, Karen K Miller
{"title":"神经活性类固醇水平在卵泡期升高,可预测患有月经相关情绪障碍的女性经前抑郁和焦虑症状的严重程度。","authors":"Allison Kimball, Jenna Bourassa, Mark L Chicote, Anu V Gerweck, Laura E Dichtel, Karen K Miller","doi":"10.1007/s00737-024-01532-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Menstrually related mood disorder (MRMD) is marked by severe affective symptoms in the late luteal phase of the menstrual cycle. We hypothesized that women with MRMD experience relative neuroactive steroid deficiency, specifically low allopregnanolone levels due to reduced conversion of progesterone, in association with the onset of affective symptoms in the late luteal phase.</p><p><strong>Methods: </strong>Nine subjects with MRMD and 14 healthy controls were studied. Daily Record of Severity of Problems was used to diagnose MRMD by DSM-5 criteria for premenstrual dysphoric disorder. Depression and anxiety symptom severity (16-Item Quick Inventory of Depressive Symptomatology Self Report, Generalized Anxiety Disorder 7-Item Scale) and levels of plasma neuroactive steroids by mass spectrometry were assessed at the mid-follicular, mid-luteal, and late luteal phases.</p><p><strong>Results: </strong>Depression severity was greater in women with MRMD than healthy controls in the late luteal phase only, as expected. In the mid-follicular phase, the mean allopregnanolone level and allopregnanolone/progesterone ratio were higher in women with MRMD than healthy controls. There were no differences between groups in luteal phase allopregnanolone levels. Higher follicular phase allopregnanolone sulfate and allopregnanolone levels were associated with greater depression severity in the mid-luteal and late luteal phases and greater anxiety severity in the late luteal phase.</p><p><strong>Conclusion: </strong>Levels of allopregnanolone, which have antidepressant effects, were higher in the mid-follicular phase in women with MRMD compared to healthy controls. In MRMD, increased conversion of progesterone to allopregnanolone in the mid-follicular phase may be a compensatory response to luteal phase depression and anxiety, or increased allopregnanolone levels could paradoxically trigger depression and anxiety.</p>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neuroactive steroid levels are elevated in the follicular phase and predict premenstrual depression and anxiety symptom severity in women with menstrually related mood disorder.\",\"authors\":\"Allison Kimball, Jenna Bourassa, Mark L Chicote, Anu V Gerweck, Laura E Dichtel, Karen K Miller\",\"doi\":\"10.1007/s00737-024-01532-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Menstrually related mood disorder (MRMD) is marked by severe affective symptoms in the late luteal phase of the menstrual cycle. We hypothesized that women with MRMD experience relative neuroactive steroid deficiency, specifically low allopregnanolone levels due to reduced conversion of progesterone, in association with the onset of affective symptoms in the late luteal phase.</p><p><strong>Methods: </strong>Nine subjects with MRMD and 14 healthy controls were studied. Daily Record of Severity of Problems was used to diagnose MRMD by DSM-5 criteria for premenstrual dysphoric disorder. Depression and anxiety symptom severity (16-Item Quick Inventory of Depressive Symptomatology Self Report, Generalized Anxiety Disorder 7-Item Scale) and levels of plasma neuroactive steroids by mass spectrometry were assessed at the mid-follicular, mid-luteal, and late luteal phases.</p><p><strong>Results: </strong>Depression severity was greater in women with MRMD than healthy controls in the late luteal phase only, as expected. In the mid-follicular phase, the mean allopregnanolone level and allopregnanolone/progesterone ratio were higher in women with MRMD than healthy controls. There were no differences between groups in luteal phase allopregnanolone levels. Higher follicular phase allopregnanolone sulfate and allopregnanolone levels were associated with greater depression severity in the mid-luteal and late luteal phases and greater anxiety severity in the late luteal phase.</p><p><strong>Conclusion: </strong>Levels of allopregnanolone, which have antidepressant effects, were higher in the mid-follicular phase in women with MRMD compared to healthy controls. In MRMD, increased conversion of progesterone to allopregnanolone in the mid-follicular phase may be a compensatory response to luteal phase depression and anxiety, or increased allopregnanolone levels could paradoxically trigger depression and anxiety.</p>\",\"PeriodicalId\":8369,\"journal\":{\"name\":\"Archives of Women's Mental Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-11-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Women's Mental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00737-024-01532-3\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Women's Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00737-024-01532-3","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Neuroactive steroid levels are elevated in the follicular phase and predict premenstrual depression and anxiety symptom severity in women with menstrually related mood disorder.
Purpose: Menstrually related mood disorder (MRMD) is marked by severe affective symptoms in the late luteal phase of the menstrual cycle. We hypothesized that women with MRMD experience relative neuroactive steroid deficiency, specifically low allopregnanolone levels due to reduced conversion of progesterone, in association with the onset of affective symptoms in the late luteal phase.
Methods: Nine subjects with MRMD and 14 healthy controls were studied. Daily Record of Severity of Problems was used to diagnose MRMD by DSM-5 criteria for premenstrual dysphoric disorder. Depression and anxiety symptom severity (16-Item Quick Inventory of Depressive Symptomatology Self Report, Generalized Anxiety Disorder 7-Item Scale) and levels of plasma neuroactive steroids by mass spectrometry were assessed at the mid-follicular, mid-luteal, and late luteal phases.
Results: Depression severity was greater in women with MRMD than healthy controls in the late luteal phase only, as expected. In the mid-follicular phase, the mean allopregnanolone level and allopregnanolone/progesterone ratio were higher in women with MRMD than healthy controls. There were no differences between groups in luteal phase allopregnanolone levels. Higher follicular phase allopregnanolone sulfate and allopregnanolone levels were associated with greater depression severity in the mid-luteal and late luteal phases and greater anxiety severity in the late luteal phase.
Conclusion: Levels of allopregnanolone, which have antidepressant effects, were higher in the mid-follicular phase in women with MRMD compared to healthy controls. In MRMD, increased conversion of progesterone to allopregnanolone in the mid-follicular phase may be a compensatory response to luteal phase depression and anxiety, or increased allopregnanolone levels could paradoxically trigger depression and anxiety.
期刊介绍:
Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.