PERIMENSTRUAL DEPRESSION - ITS RELATIONSHIP TO PAIN, BLEEDING, AND PREVIOUS HISTORY OF DEPRESSION

Daily ratings of depression, pain, and menstrual blood loss, as well a s past history of treated depression, were analyzed in 210 women atten ding a Premenstrual Syndrome Clinic. Severity and duration of perimens trual depression was strongly associated with the severity of premenst rual and menstrual pain, raising the possibility of a causal relations hip. It is not yet clear whether the occurrence of depression alters a woman's perception of pain, pain aggravates a tendency to perimenstru al depression, or some common factor aggravates both. A relationship b etween depression and subjective ratings of bloodless was also observe d but was less marked than the relationship with pain. Both relationsh ips had been reported in an earlier study using retrospective ratings. A relationship between past history of treated depression and severit y and timing of current perimenstrual depression, observed previously, was not found in this study. This discrepancy was not due to differen ces between retrospective and prospective methods of assessment, but m ay have partly resulted from differences in the reporting of premenstr ual pain in the two studies. Further studies of this association shoul d control for the confounding effect of pain.