The Prevalence and Associated Factors of Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) among Preclinical Medical Students at Chulalongkorn University
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Abstract
Objective: To determine the prevalence and associated factors of moderate to severe premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) among pre-clinical medical student at Chulalongkorn university.
Methods: A cross-sectional descriptive study was conducted in 224 pre-clinical medical students at Chulalongkorn university during September 2024 to October 2024. Participants were asked to complete the self-administered questionnaires consisting of personal and menstrual-related information, Lifestyles information, Premenstrual Symptoms screening tool (PSST) – Thai version and 10-Item Perceived Stress Scale-10 (T-PSS-10) – Thai version. The data were analyzed using descriptive and inferential statistics such as Chi-square, Fisher’s exact test, independent t-test and logistic regression analysis.
Results: The study included 224 participants. The prevalence of moderate to severe PMS and PMDD were 36.6% and 4.46%, respectively. According to logistic regression analysis, GPAX (adjusted odds ratio (aOR) = 0.33, 95%CI = 0.11 - 0.95, p = 0.039), family history of PMS or PMDD (aOR = 3.16, 95%CI = 1.11 - 9.04, p = 0.032) and a total score of the Perceived Stress Scale, Thai version (T-PSS-10) (aOR = 1.17, 95%CI = 1.08 - 1.27, p < 0.001) were significantly associated with moderate to severe PMS. While class absenteeism (aOR = 22.74, 95%CI = 2.04 - 253.75, p = 0.011), consumption of bakery products (aOR = 0.020, 95%CI = 0.002 - 0.27, p = 0.003) and a total score of T-PSS-10 (aOR = 1.29, 95%CI = 1.05 - 1.58, p = 0.016) were significantly associated with PMDD.
Conclusion: Our study found that approximately one-third of the sample experience PMS and nearly 5% had PMDD. Increased total score on the Perceived Stress Scale were associated with both PMS and PMDD. Therefore, screening and mental health promotion including stress management, should be provided for preclinical medical students.
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References
Hantsoo L, Rangaswamy S, Voegtline K, Salimgaraev R, Zhaunova L, Payne JL. Premenstrual symptoms across the lifespan in an international sample: data from a mobile application. Arch Womens Ment Health 2022;25(5):903-10.
Roomruangwong C. The psychiatric aspects in female. Bangkok: Department of Psychiatry, Faculty of Medicine, Chulalongkorn university 2021.
Attieh E, Maalouf S, Richa S, Kesrouani A. Premenstrual syndrome among Lebanese medical students and residents. Int J Gynaecol Obstet 2013;121(2):184-5.
Shah RS, Christian DS. Association of socio-demographic, dietary and lifestyle factors with premenstrual syndrome (PMS) among undergraduate medical students of a tertiary care institute in Ahmedabad, Gujarat. J Family Med Prim Care 2020;9(11):5719-24.
Direkvand–Moghadam A, Sayehmiri K, Delpisheh A, Kaikhavandi S. Epidemiology of premenstrual syndrome (PMS) - a systematic review and meta-analysis study. J Clin Diagn Res 2014;8(2):106-9.
Rezende APR, Alvarenga FR, Ramos M, Franken DL, Dias da Costa JS, Pattussi MP, et al. Prevalence of premenstrual syndrome and associated factors among academics of a university in midwest Brazil. Rev Bras Ginecol Obstet 2022;44(2):133-41.
Thakrar P, Bhukar K, Oswal R. Premenstrual dysphoric disorder: Prevalence, quality of life and disability due to illness among medical and paramedical students. J Affect Disord Rep 2021.
American Psychiatric Association. Diagnostic and statistical manual of mental Disorders, Fifth edition (DSM-5). 5th ed. Arlington, VA: American Psychiatric Association Publishing 2013.
Geta TG, Woldeamanuel GG, Dassa TT. Prevalence and associated factors of premenstrual syndrome among women of the reproductive age group in Ethiopia: systematic review and meta-analysis. PLoS One 2020;15(11):e0241702.
Nowakowski S, Haynes P, Parry B. Premenstrual Dysphoric Disorder. In: Fink G, editor. Encyclopedia of Stress. 2nd ed. Cambridge: Acedemic Press; 2007;173-9.
Salamat S, Ismail KMK, O’ Brien S. Premenstrual syndrome. Obstetrics, Gynaecology & Reproductive Medicine 2008;18(2):29-32.
Dumrongpiwat N, Roomruangwong C. Prevalence and associated factors of premenstrual syndrome and premenstrual dysphoric disorder among psychiatric outpatients with mood and anxiety disorders. Chula Med Bull 2020;2(1):15-25.
Fernández MDM, Saulyte J, Inskip HM, Takkouche B. Premenstrual syndrome and alcohol consumption: a systematic review and meta-analysis. BMJ Open 2018; 8(3):e019490.
Hashim MS, Obaideen AA, Jahrami HA, Radwan H, Hamad HJ, Owais AA, et al. Premenstrual syndrome is associated with dietary and lifestyle behaviors among university students: a cross-sectional study from Sharjah, UAE. Nutrients 2019;11(8):1939.
Akoku DA, Vukugah TA, Tihnje MA, Nzubepie IB. Oral contraceptive use and premenstrual syndrome among sexually active female university students in Cameroon. Pan Afr Med J 2020;36:333.
de Wit AE, de Vries YA, de Boer MK, Scheper C, Fokkema A, et al. Efficacy of combined oral contraceptive for depressive symptoms and overall symptomatology in premenstrual syndrome: pairwise and network meta-analysis of randomized trials.Am J Obstet Gynecol 2021;225(6):624-33.
Heinen I, Bullinger M, Kocalevent RD. Perceived stress in first year medical students - associations with personal resources and emotional distress. BMC Med Educ 2017;17(1):4.
Vyas KS, Stratton TD, Soares NS. Sources of medical student stress. Educ Health (Abingdon) 2017;30(3):232-5.
Sothornwit J, Chongsomchai C, Kaewrudee S, Chumworathayi B, Soontrapa S. Prevalence of premenstrual syndrome (PMS) and its impact among Thai pre-clinical medical students. Srinagarind Med J 2012;27.
Alshdaifat E, Absy N, Sindiani A, AlOsta N, Hijazi H, Amarin Z, et al. Premenstrual syndrome and its association with perceived stress: the experience of medical students in Jordan. Int J Womens Health 2022;14:777-85.
Krejcie RV, Morgan DW. Determining sample size for research activities. EducPsycholMeas 1970;30(3):607-10.
Chayachinda C, Rattanachaiyanont M, Phattharayuttawat S, Kooptiwoot S. Premenstrual syndrome in Thai nurses. J Psychosom Obstet Gynaecol 2008;29(3):199-205.
Steiner M, Macdougall M, Brown E. The premenstrual symptoms screening tool (PSST) for clinicians. Arch Womens Ment Health 2003;6(3):203-9.
Wongpakaran N, Wongpakaran T. The Thai version of the PSS-10: an investigation of its psychometric properties. Biopsychosoc Med 2010;4:6.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. JHealthSocBehav 1983;24:385-96.
Jha RK, Jha M. Prevalence of premenstrual dysphoric disorder among female students of a medical college in Nepal: a descriptive cross-sectional study. JNMA J Nepal Med Assoc 2022;60:72-6.
Suboohi S, Pario S, Nasim G, Abbasi S, Siddiqui SH. Assessment of premenstrual syndrome In medical students and its association with progression of academic years. Journal of Bahria University Medical and Dental College 2019;9(3):210-3.
Tolossa FW, Bekele ML. Prevalence, impacts and medical managements of premenstrual syndrome among female students: cross-sectional study in college of health sciences, Mekelle University, Mekelle, Northern Ethiopia. BMC Womens Health 2014;14:52.
Hsiao MC, Hsiao CC, Liu CY. Premenstrual symptoms and premenstrual exacerbation in patients with psychiatric. Psychiatry Clin Neurosci 2004;58(2):186-90.
Thaweesuksiri M, Waleeprakhon P. Premenstrual dysphoric disorder in major depression patients at the outpatient psychiatric department of Ramathibodi hospital. J Psychiatr Assoc Thailand 2013;58(2):165-74.
Adewuya AO, Loto OM, Adewumi TA. Premenstrual dysphoric disorder amongst Nigerian university students: prevalence, comorbid conditions, and correlates. Arch Womens Ment Health 2008;11:13-8.
Tadakawa M, Takeda T, Monma Y, Koga S, Yaegashi N. The prevalence and risk factors of school absenteeism due to premenstrual disorders in Japanese high school students—a school-based cross-sectional study. Biopsychosoc Med 2016;10:13.
Aoki M, Suzuki M, Suzuki S, Takao H, Okayama H. Cognitive function evaluation in premenstrual syndrome during the follicular and luteal phases using near-infrared spectroscopy. Comprehensive pyschoneuroendocrinology 2022;10:100117.
Beddig T, Reinhard I, Kuehner C. Stress, mood, and cortisol during daily life in women with Premenstrual Dysphoric Disorder (PMDD). Psychoneuroendocrinology 2019;109:104372.
Wurtman JJ, Brzezinski A, Wurtman RJ, Laferrere B. Effect of nutrient intake on premenstrual depression. Am J Obstet Gynecol 1989;161(5):1228-3
Purdue-Smithe AC, Manson JE, Hankinson S, Bertone-Johnson ER. A prospective study of caffeine and coffee intake and premenstrual syndrome. Am J Clin Nutr 2016;104(2):499-507.
Henkaew W, Jaisit J. Factors related to premenstrual syndrome among female nursing students. J Royal Thai Army Nurses 2018;19:299-310.
Seedhom AE, Mohammed ES, Mahfouz EM. Life style factors associated with premenstrual syndrome among El-Minia university students, Egypt. Int Sch Res Notices 2013; 2013: 61712