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      Associations between psychological distress in adolescence and menstrual symptoms across life: Longitudinal evidence from the 1970 British Cohort Study

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          Abstract

          Purpose

          This study aimed to investigate the association between psychological distress (PD) at age 16 and menstrual symptoms experienced across women's life.

          Methods

          Up to 2584 females from the 1970 British Cohort Study, a study of individuals born within one week in 1970, were included. PD at age 16 was measured with the 12-item General Health Questionnaire. Three categories were derived: low PD (<11), moderate PD (11–15), and severe PD (>15). Five menstrual health symptoms were self-reported at each age (16, 30 and 42 years). Binomial logistic regressions examined associations between PD at age 16 and each individual symptom, adjusted for age of menarche, sleep and appetite problems, physical activity levels and socioeconomic position.

          Results

          The most prevalent symptoms were “pain” (61 %), “painful period” (10 %) and “heavy period” (33 %) at ages 16, 30 and 42, respectively. At age 16, those with severe PD were more likely to experience depression (OR: 2.92; 95% CI: 2.31, 3.70)), irritability (1.67; 1.33, 2.11), menstrual pain (1.34; 1.01, 1.80), and headaches (1.29; 1.02, 1.63). A weak association was found between severe PD at age 16 and pre-menstrual tension at age 30 (1.72; 1.01, 2.83). At age 42, those with severe PD at age 16 were more likely to experience pre-menstrual tension (1.89; 1.46, 2.44), painful periods (1.64; 1.27, 2.11), and heavy periods (1.28; 1.00, 1.62).

          Discussion

          Menstruating females with higher levels of PD in adolescence have an increased risk of menstrual symptoms across adolescence, early and mid-adulthood. Our findings suggest the need to consider early-life psychological interventions to improve women's menstrual experiences across their reproductive years.

          Highlights

          • We investigated associations between psychological distress (PD) and menstrual symptoms.

          • PD at 16y was strongly associated with menstrual symptoms at ages 16, 30 and 42.

          • Associations were strongest for mood-based symptoms (e.g. depression, irritability).

          • Study highlights links between emotional and menstrual health over a 25-year period.

          • Exploration of early-life psychological interventions for menstrual health is needed.

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          Most cited references34

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          The prevalence and risk factors of dysmenorrhea.

          Dysmenorrhea is a common menstrual complaint with a major impact on women's quality of life, work productivity, and health-care utilization. A comprehensive review was performed on longitudinal or case-control or cross-sectional studies with large community-based samples to accurately determine the prevalence and/or incidence and risk factors of dysmenorrhea. Fifteen primary studies, published between 2002 and 2011, met the inclusion criteria. The prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain in 2%-29% of the women studied. Women's age, parity, and use of oral contraceptives were inversely associated with dysmenorrhea, and high stress increased the risk of dysmenorrhea. The effect sizes were generally modest to moderate, with odds ratios varying between 1 and 4. Family history of dysmenorrhea strongly increased its risk, with odds ratios between 3.8 and 20.7. Inconclusive evidence was found for modifiable factors such as cigarette smoking, diet, obesity, depression, and abuse. Dysmenorrhea is a significant symptom for a large proportion of women of reproductive age; however, severe pain limiting daily activities is less common. This review confirms that dysmenorrhea improves with increased age, parity, and use of oral contraceptives and is positively associated with stress and family history of dysmenorrhea.
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            Measuring socioeconomic position in health research.

            In this article we review different measures of socioeconomic position (SEP) and their uses in health-related research. Socioeconomic circumstances influence health. Generally, poorer socioeconomic circumstances lead to poorer health. This has generated a search for generic mechanisms that could explain such a general association. However, we propose that there is a greater variation in the association between SEP and health than is generally acknowledged when specific health outcomes are investigated. We propose that studying these variations provide a better understanding of the aetiological mechanisms relating specific diseases with specific exposures. AREAS TO DEVELOP RESEARCH: Using different indicators of SEP in health research can better capture these variations and is important when evaluating the full contribution of confounding by socioeconomic conditions. We propose that using an array of SEP indicators within a life course framework also offers considerable opportunity to explore causal pathways in disease aetiology.
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              Factors contributing to psychological distress in the working population, with a special reference to gender difference

              Background Psychological distress refers to non-specific symptoms of stress, anxiety and depression, and it is more common in women. Our aim was to investigate factors contributing to psychological distress in the working population, with a special reference to gender differences. Methods We used questionnaire data from the nationally representative Finnish Regional Health and Well-being Study (ATH) collected in the years 2012–2016 (target population participants aged 20 +, n = 96,668, response rate 53%), restricting the current analysis to those persons who were working full-time and under 65 of age (n = 34,468). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5) (cut-off value <=52). We studied the following factors potentially associated with psychological distress: sociodemographic factors, living alone, having children under18 years of age, lifestyle-related factors, social support, helping others outside of the home and work-related factors. We used logistic regression analysis to examine association between having work-family conflict with the likelihood for psychological distress. We first performed the models separately for men and women. Then interaction by gender was tested in the combined data for those independent variables where gender differences appeared probable in the analyses conducted separately for men and women. Results Women reported more psychological distress than men (11.0% vs. 8.8%, respectively, p < 0.0001). Loneliness, job dissatisfaction and family-work conflict were associated with the largest risk of psychological distress. Having children, active participation, being able to successfully combine work and family roles, and social support were found to be protective factors. A significant interaction with gender was found in only two variables: ignoring family due to being absorbed in one’s work was associated with distress in women (OR 1.30 (95% CI 1.00–1.70), and mental strain of work in men (OR 2.71 (95% CI 1.66–4.41). Conclusions Satisfying work, family life and being able to successfully combine the two are important sources of psychological well-being for both genders in the working population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10560-y.
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                Author and article information

                Contributors
                Journal
                J Affect Disord
                J Affect Disord
                Journal of Affective Disorders
                Elsevier/North-Holland Biomedical Press
                0165-0327
                1573-2517
                01 June 2024
                01 June 2024
                : 354
                : 712-718
                Affiliations
                [a ]Institute of Sport, Exercise & Health, Division of Surgery and Interventional Science, UCL, London, UK
                [b ]Faculty of Mathematical and Physical Sciences, UCL, London, UK
                [c ]University College London Hospitals NIHR Biomedical Research Centre, London, UK
                Author notes
                [* ]Corresponding author at: Institute of Sport, Exercise & Health, 170 Tottenham Court Road, W1T 7HA London, UK. Joanna.blodgett@ 123456ucl.ac.uk
                Article
                S0165-0327(24)00484-1
                10.1016/j.jad.2024.03.069
                11752839
                38494131
                21a54811-3313-4994-b908-63c6360fd00c
                © 2024 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 November 2023
                : 18 February 2024
                : 9 March 2024
                Categories
                Research Paper

                Clinical Psychology & Psychiatry
                psychological distress,menstrual symptoms,reproductive health,life course,risk prediction,adolescent health,genecology

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