DISCUSSION
In this study, we aimed to determine the relationship between D type
personality and PMS on 286 women (200 in the control group, 86 in the
PMS group). As a result of the research, we found that there is a
relationship between Type D personality and pms. NA, SI and Type D
personality were significantly higher in women in the PMS group than in
the control group. In addition, the frequency of depression and the
severity of depression were also higher in women with PMS.
Premenstrual symptoms include mood, behavioral and physical symptoms
that occur in a cyclic pattern before menstruation in women of
reproductive age, and decrease after menstruation
(11). Depressive symptoms can also be
seen in the premenstrual period. Approximately 65% of women with
unipolar depression experienced PMS (12).
It is known that women have 2 times more major depressive disorders than
men (13). According to studies, it was
found that there is a significant relationship between depression risk
and PMS (14). It is known that the rate
of majör depressive disorder in women is 2 times higher than in men
worldwide (13). Similar results of
increased rates of depression in those suffering from PMS have been
found by other authors (15-18). Our
results concur with previous findings as we observed presence of
depressive symptoms to be associated with PMS. Depression was also found
to be more severe in PMS group compared to the controls in the recent
research. Studies and our results show that the relationship between pms
and depression should be investigated.
Type D personality refers to individuals with a common tendency towards
negative affectivity (NA) and social inhibition (SI). In studies
conducted, it is stated that Type D personality traits are seen in
21-33% of the population (19).
Relationships between Type D personality traits and diseases have been
investigated in recent years.
This personality trait is linked to biological and behavioral mechanisms
which may affect health. Neuroendocrine and immunologic pathways have
been investigated to explain the negative clinical outcomes for patients
with Type D personality and increased pro-inflammatory immune activation
(20), oxidative stress
(6), and cortisol levels
(21) found to be related to Type D
personality. Type D personality is related to depression, anxiety,
somatisation (22), dysregulated stress
reactivity (23), sleep problems,
psychosomatic symptoms, musculoskeletal pain
(24), lower subjective quality of life
(25), adverse health behaviours
(26).
Although there are many studies evaluating the relationship between
depression and PMS, this is the first study to examine the effect of
Type D personality on PMS. In our study, a positive relationship was
found between Type D personality and the presence of PMS. NA and SI
scores were also strongly correlated with PMSS scores.
In studies performed, the prevalence of PMS and (Premenstrual dystrophic
disorder) PMDD was found to be higher in young, physically inactive
women, menarche age 12 or older and physically inactive
(27-29).
Similar to previous studies, we found a negative correlation between
PMSS score and menarche age in our study, but this negative effect
disappeared in regression analysis. To exclude the effect of the factors
that known to affect PMS via regression analysis could be the
neutraulization of the association between age at menarche and the
presence of PMS. In contrast, PMS was not associated with age, BMI, and
women who do sportic activity in our study. Small sample size and the
definition of ‘physically inactive’ person could be the reason of
discrepancy in the results with the previous studies. In the literature,
PMS also increases in women with menstrual irregularities
(30), a long menstrual duration and
cycles (31). In our study, there was no
significant relationship between the features of the menstrual cycle and
PMS, but it was found that the menstrual bleeding volume was
significantly higher in the pms group. A strong association between the
duration of the menstrual period and volume of bleeding could explain
the discrepancies in the results with the previous studies
(3, 32).
Smoking and alcohol use during adolescent period has been found to be a
risk factor for PMS (3,
32). We could not found any differences
in terms of smoking and alcohol use between PMS and control groups.
Longitudinal studies evaluating the association between age, obesity,
exercise and PMS should be conducted.
The limitation is that the data of this study were obtained from
participants through self‐reported questionnaire, which may reflect bias
in self‐reporting (i.e. participants may have underestimated or
overestimated their level of PMS and PMDD symptoms). Further large
sample-sized investigations should be performed to investigate the
underlying cause for the pathogenetic mechanism of the relationship
between Type D personality and PMS. Despite aferomentioned limitations,
an association between Type D personality and PMS was shown for the
first time.