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经前期综合征与经前焦虑障碍的临床表现及诊断

Authors
Kimberly A Yonkers, MD
Robert F Casper, MD
Section Editors
Robert L Barbieri, MD
William F Crowley, Jr, MD
Deputy Editor
Kathryn A Martin, MD
Translators
常青, 主任医师，教授

引言

经前期综合征(premenstrual syndrome, PMS)的特征是存在躯体及行为症状，这些症状周期性出现于月经周期后半期并干扰女性生活的某些方面。美国精神病学会(American Psychiatric Association, APA)将经前焦虑障碍(premenstrual dysphoric disorder, PMDD)定义为PMS的严重形式，其突出症状为愤怒、易激惹性及精神紧张。 (参见下文‘评估’)

本专题将总结PMS和PMDD的临床表现和诊断。此类疾病的流行病学、发病机制和治疗将单独讨论。 (参见“Epidemiology and pathogenesis of premenstrual syndrome and premenstrual dysphoric disorder”和“经前期综合征和经前期焦虑障碍的治疗”)

定义

大多数育龄女性在月经开始前都会经历1-2日的一种或多种轻微的情绪或躯体症状(图 1)。诸如乳房酸痛和腹胀感等轻微症状不会导致苦恼或功能障碍，这些症状不被认为代表PMS[1]。

相对而言，美国妇产科医师学会(American College of Obstetricians and Gynecologists, ACOG)将有临床意义的PMS定义为：在月经开始前5日期间出现至少一种“经济或社会功能障碍”相关症状，且这一情况出现于至少3个连续的月经周期(图 1)。症状可能是情感性(例如，愤怒爆发、抑郁)或躯体性的(如，乳房疼痛和腹胀感)(表 1)。 (参见下文‘评估’)

PMDD是最严重的形式，将在下文介绍。 (参见下文‘PMDD’)

                        

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Literature review current through: 2017-06 . | This topic last updated: 2016-02-10.
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