{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:25:58Z","timestamp":1792682758770,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,8,28]],"date-time":"2017-08-28T00:00:00Z","timestamp":1503878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["N01MH80001"],"award-info":[{"award-number":["N01MH80001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The impact of comorbid premenstrual dysphoric disorder (<jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content>) in women with bipolar disorder (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>) is largely unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We compared illness characteristics and female\u2010specific mental health problems between women with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> with and without <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods<\/jats:title><jats:p>A total of 1 099 women with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> who participated in the Systematic Treatment Enhancement Program for Bipolar Disorder (<jats:styled-content style=\"fixed-case\">STEP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>) were studied. Psychiatric diagnoses and illness characteristics were assessed using the Mini International Neuropsychiatric Interview. Female\u2010specific mental health was assessed using a self\u2010report questionnaire developed for <jats:styled-content style=\"fixed-case\">STEP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content> diagnosis was based on <jats:styled-content style=\"fixed-case\">DSM<\/jats:styled-content>\u20105 criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women with comorbid <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content> had an earlier onset of bipolar illness (<jats:italic>P<\/jats:italic> &lt; 0.001) and higher rates of rapid cycling (<jats:italic>P<\/jats:italic> = 0.039), and increased number of past\u2010year hypo\/manic (<jats:italic>P<\/jats:italic> = 0.003), and lifetime\/past\u2010year depressive episodes (<jats:italic>P<\/jats:italic> &lt; 0.05). Comorbid <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content> was also associated with higher proportion of panic disorder, post\u2010traumatic stress disorder, generalized anxiety disorder, bulimia nervosa, substance abuse, and adult attention deficit disorder (all <jats:italic>P<\/jats:italic> &lt; 0.05). There was a closer gap between <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> onset and age of menarche in women with comorbid <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.003). Women with comorbid <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content> reported more severe mood symptoms during the perinatal period and while taking oral contraceptives (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The results from this study is consistent with research suggesting that sensitivity to endogenous hormones may impact the onset and the clinical course of BD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The comorbidity between <jats:styled-content style=\"fixed-case\">PMDD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> is associated with worse clinical outcomes and increased illness burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.12797","type":"journal-article","created":{"date-parts":[[2017,8,28]],"date-time":"2017-08-28T16:42:50Z","timestamp":1503938570000},"page":"473-482","source":"Crossref","is-referenced-by-count":46,"title":["Increased illness burden in women with comorbid bipolar and premenstrual dysphoric disorder: data from 1 099 women from STEP\u2010BD study"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0179-2129","authenticated-orcid":false,"given":"A.","family":"Slyepchenko","sequence":"first","affiliation":[{"name":"MiNDS Neuroscience Graduate Program McMaster University Hamilton ON Canada"},{"name":"Women's Health Concerns Clinic St. Joseph's Healthcare Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. N.","family":"Frey","sequence":"additional","affiliation":[{"name":"MiNDS Neuroscience Graduate Program McMaster University Hamilton ON Canada"},{"name":"Women's Health Concerns Clinic St. Joseph's Healthcare Hamilton ON Canada"},{"name":"Mood Disorders Program Department of Psychiatry and Behavioural Neurosciences McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Lafer","sequence":"additional","affiliation":[{"name":"Bipolar Disorder Research Program Department of Psychiatry University of S\u00e3o Paulo Medical School Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Nierenberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Harvard Medical School Boston MA USA"},{"name":"Massachusetts General Hospital Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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