Annette Haywood1, Pauline Slade, Helen King. 1. South East Sheffield Primary Care Trust, 9 Orgreave Road, Sheffield S13 9LQ, UK. Annette.haywood@sheffieldse-pct.nhs.uk
Abstract
BACKGROUND: There is a widely held assumption in the literature that a well-established link exists between postnatal depressive and premenstrual symptoms. However, on examination of existing research, certain methodological limitations were identified including inadequate methods of assessment and a heavy reliance upon the retrospective assessment of either postnatal or premenstrual symptoms, giving rise to concern regarding the validity of any conclusions. METHODS: A community sample of 63 women completed a daily menstrual symptom diary for two consecutive months. Women's Edinburgh Postnatal Depression Scale score, recorded 1-3 years previously, was provided by their Health Visitor. RESULTS: Only one participant showed evidence of both postnatal and premenstrual distress when using an EPDS cut-off of >12 and defined criteria for premenstrual symptom assessment. When scores were treated as a continuum, there was no association between postnatal distress and psychological premenstrual symptoms and only a trend towards significance between postnatal distress and physical premenstrual symptoms. LIMITATIONS: Due to the recruitment method, there is some uncertainty regarding the overall response rate. Although this was not a large sample, it compares favourably with many other studies where daily data are collected. The particular focus was examining whether postnatal depressive symptoms predict premenstrual distress (not vice versa). CONCLUSIONS: This study found little evidence to support the widely held assumption of a clear relationship between postnatal distress and premenstrual symptoms.
BACKGROUND: There is a widely held assumption in the literature that a well-established link exists between postnatal depressive and premenstrual symptoms. However, on examination of existing research, certain methodological limitations were identified including inadequate methods of assessment and a heavy reliance upon the retrospective assessment of either postnatal or premenstrual symptoms, giving rise to concern regarding the validity of any conclusions. METHODS: A community sample of 63 women completed a daily menstrual symptom diary for two consecutive months. Women's Edinburgh Postnatal Depression Scale score, recorded 1-3 years previously, was provided by their Health Visitor. RESULTS: Only one participant showed evidence of both postnatal and premenstrual distress when using an EPDS cut-off of >12 and defined criteria for premenstrual symptom assessment. When scores were treated as a continuum, there was no association between postnatal distress and psychological premenstrual symptoms and only a trend towards significance between postnatal distress and physical premenstrual symptoms. LIMITATIONS: Due to the recruitment method, there is some uncertainty regarding the overall response rate. Although this was not a large sample, it compares favourably with many other studies where daily data are collected. The particular focus was examining whether postnatal depressive symptoms predict premenstrual distress (not vice versa). CONCLUSIONS: This study found little evidence to support the widely held assumption of a clear relationship between postnatal distress and premenstrual symptoms.