Psychosocial Functioning in Women With Premenstrual Dysphoric Disorder Before and After Treatment With Sertraline or Placebo
J Clin Psychiatry 2000;61(2):101-109
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The objective of this study was to
evaluate the pretreatment psychosocial functioning of women with
premenstrual dysphoric disorder (PMDD) and the effect of
sertraline treatment on psychosocial functioning in these
Method: Two hundred forty-three women recruited
from 12 university-affiliated sites and meeting DSM-IV criteria
for PMDD completed 1 cycle of single-blind placebo and were
randomly assigned to flexible dose sertraline or placebo for 3
cycles. Psychosocial functioning was assessed by the Daily Record
of Severity of Problems (DRSP), the Social Adjustment Scale
(SAS), and the Quality of Life Enjoyment and Satisfaction
Results: SAS scores during the follicular phase
were similar to SAS scores of community norms, whereas the
pretreatment SAS and Q-LES-Q scores during the luteal phase were
similar to scores of women with depressive disorders. Sertraline
was significantly more effective than placebo in improving
psychosocial functioning as measured by the SAS, the Q-LES-Q, and
the 3 DRSP items of impaired productivity, interference with
social activities, and interference with relationships with
others. Improvement in psychosocial functioning assessed by SAS
and Q-LES-Q correlated with improvement in symptomatology
assessed by the Clinical Global Impressions-Improvement (CGI-I)
scale and the Hamilton Rating Scale for Depression (HAM-D).
Remitters (CGI-I score of 1) were more likely to function better
at baseline and showed larger improvements in functioning and
quality of life with treatment compared with nonremitters.
Conclusion: Sertraline was superior to placebo
in improving psychosocial functioning in women with PMDD as
reflected by SAS, Q-LES-Q, and DRSP measures. Functional
improvement correlated with improvement in premenstrual
symptomatology and was apparent by the second cycle of treatment.
Comparison of pretreatment SAS scores in women with PMDD with the
scores of other populations of women documents the degree of
luteal phase functional impairment in women with PMDD and a
relative absence of follicular phase impairment.