Premenstrual Mood Disorders and Postpartum Depression: Similar But Different

Premenstrual Mood Disorders and Postpartum Depression: Similar But Different

It has been hypothesized that both premenstrual dysphoric disorder (PMDD) and postpartum depression (PPD) occur as the result of rapid shifts in the levels of ovarian hormones. Data regarding the prevalence of PPD among women with documented PPD is sparse, and the existent studies rely upon recall of premenstrual symptoms which is notoriously inaccurate.  Despite this lack of information, we often tell women with PMDD that they may be at increased risk for postpartum depression.  A new study calls this assumption into question.

This study included 215 women between the ages of 19 and 51 years who sought treatment for PMDD and had a confirmed diagnosis of PMDD.  Using the Structured Clinical Interview for DSM-III-R or -IV, the frequency of PPD was established in the subgroup of women (n = 137) who had delivered at least one child.

In this subgroup of women, 43.3% had a past history of a mood disorder (either major [n = 67; 31.2%] or minor [n = 10; 4.7%] depression or PPD.  Interestingly only 16 women with PMDD (7.4%) had a history of PPD.

The findings of this study are somewhat surprising, suggesting that PMDD and PPD do not frequently co-occur. These data suggest that PMDD and PPD do not share a similar pathophysiology beyond being ovarian-steroid-triggered mood disorders.

Ruta Nonacs, MD PhD

Kepple AL, Lee EE, Haq N, Rubinow DR, Schmidt PJ.  History of postpartum depression in a clinic-based sample of women with premenstrual dysphoric disorder.  J Clin Psychiatry. 2016 Mar 15. [Epub ahead of print]

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