Psychiatric morbidity was studied in 100 women attending gynecological outpatient and inpatient set-ups using two brief screening instruments: the General Health Questionnaire, 12 items, and the Present State Examination, ten short questions. Psychiatric morbidity was detected in 36% and was found to be higher in women with uterine prolapse and infections but not in those with menstrual irregularities (p < 0.001). The commonest psychiatric symptoms detected in this population were worrying (50%), aches and pains (51%), depression (50%) and disturbances of biological function (51%). The commonest diagnoses were neurotic depression (70%) and adjustment disorders (23%). The screening instruments used were found to be simple, sensitive, specific, with high identification indices and easy to administer.
Premenstrual experiences were studied in 112 non-complaining women using the Premenstrual Assessment Forms I (for positive experiences), II (for distressing experiences) and the bi-directional Visual Analog Scale. Overall, 27% of women reported no or minimal changes, 20% reported predominantly negative experiences, and 18% predominantly positive feelings. However, the commonest experience was a mixed picture with coexisting positive and negative feelings in 35% of the subjects. Severe premenstrual changes were noted in only nine (8%) of the women. None had a late luteal phase dysphoric disorder. The 26 items of the Premenstrual Assessment Forms I and II were factor analyzed by the principal components method using a varimax rotation. Four factors were derived. Factor I had 12 items indicating negative experiences. Factor II had seven items indicating positive feelings. The other two factors have vegetative features (like sleep and bowel changes) and sexual feelings. The findings also indicated that research needs to be directed towards understanding the mixed group of symptoms rather than the excessive emphasis on negative feelings.
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