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Assoziierte depressive Symptome umfassen Stimmungsschwankungen, Depressivit\u00e4t und Gereiztheit, weshalb affektive St\u00f6rungen eine relevante Differenzialdiagnose darstellen. Etwa 3\u20138\u202f% aller Frauen im geb\u00e4rf\u00e4higen Alter leiden an einem pr\u00e4menstruellen Syndrom, w\u00e4hrend etwa 2\u202f% von einer pr\u00e4menstruellen dysphorischen St\u00f6rung betroffen sind. Es werden genetische und soziobiografische Risikofaktoren diskutiert. Dar\u00fcber hinaus werden genetische Polymorphismen spezifischer Hormonrezeptoren als urs\u00e4chlich angenommen. Pathophysiologisch zentral scheint eine komplexe Interaktion von zyklischen hormonellen Ver\u00e4nderungen und dem zentralen Neurotransmitterhaushalt zu sein. Ein Ungleichgewicht der Wirkungen von \u00d6strogen und Progesteron in der Lutealphase wird als endokrine Ursache der Symptomatik angenommen. Aus diesem Grunde wird h\u00e4ufig ein initialer Therapieversuch mittels Progesteronsubstitution in der zweiten Zyklush\u00e4lfte durchgef\u00fchrt, wobei die Evidenz diesbez\u00fcglich begrenzt ist. Auch die Gabe oraler kombinierter Kontrazeptiva stellt eine Option dar. Insbesondere f\u00fcr die Behandlung mit selektiven Serotoninwiederaufnahmehemmer (SSRI) existieren zahlreiche Wirkbelege. In schweren F\u00e4llen kann die Gabe von GnRH(Gonadotropin-Releasing-Hormon)-Analoga mit Add-back-Therapie erwogen werden. Insbesondere im Bereich affektiver St\u00f6rungen stellen pr\u00e4menstruelle Syndrome klinisch relevante Differenzialdiagnosen und Komorbidit\u00e4ten dar, die Behandler vor besondere klinische Herausforderungen stellen. Diese \u00dcbersichtsarbeit soll der Leserschaft daher eine klinische Orientierung im Umgang mit diesem St\u00f6rungsbild geben.<\/jats:p>","DOI":"10.1007\/s00115-024-01625-5","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T14:06:46Z","timestamp":1708697206000},"page":"268-274","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pr\u00e4menstruelles Syndrom und pr\u00e4menstruelle dysphorische St\u00f6rung\u00a0\u2013 \u00dcbersicht zu Pathophysiologie, Diagnostik und Therapie","Premenstrual syndrome and premenstrual dysphoric disorder\u2014Overview on pathophysiology, diagnostics and treatment"],"prefix":"10.1007","volume":"95","author":[{"given":"Jana","family":"Hau\u00dfmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Goeckenjan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hau\u00dfmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Wimberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"issue":"2","key":"1625_CR1","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1001\/archfami.8.2.122","volume":"8","author":"PA Deuster","year":"1999","unstructured":"Deuster\u00a0PA, Adera\u00a0T, South-Paul\u00a0J (1999) Biological, social, and behavioral factors associated with premenstrual syndrome. 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