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REVIEW article

Front. Psychiatry
Sec. Public Mental Health
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1448914
This article is part of the Research Topic Psychiatric Illness Across the Menstrual Cycle View all 7 articles

The Behavioral and Physiological Correlates of Affective Mood Switching in Premenstrual Dysphoric Disorder

Provisionally accepted
Robin Brown Robin Brown 1*Erin Bondy Erin Bondy 2Gabriel S. Dichter Gabriel S. Dichter 1,2,3Julianna Prim Julianna Prim 2Crystal E. Schiller Crystal E. Schiller 2
  • 1 Department of Psychology and Neuroscience, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • 2 Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • 3 Carolina Institute for Developmental Disabilities, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

The final, formatted version of the article will be published soon.

    Premenstrual dysphoric disorder (PMDD), a more severe manifestation of premenstrual syndrome (PMS), is characterized by emotional, behavioral, and physical symptoms that begin in the mid-to-late luteal phase of the menstrual cycle, when estradiol and progesterone levels precipitously decline, and remit after the onset of menses. Remotely monitoring physiologic variables associated with PMDD depression symptoms, such as heart rate variability (HRV), sleep, and physical activity, holds promise for developing an affective state prediction model. Switching into and out of depressive states is associated with an increased risk of suicide, and therefore, monitoring periods of affective switching may help mitigate risk. Management of other chronic health conditions, including cardiovascular disease and diabetes, has benefited from remote digital monitoring paradigms that enable patients and physicians to monitor symptoms in real-time and make behavioral and medication adjustments. PMDD is a chronic condition that may benefit from real-time, remote monitoring. However, clinical practice has not advanced to monitoring affective states in real-time. Identifying remote monitoring paradigms that can detect within-person affective state change may help facilitate later research on timely and efficacious interventions for individuals with PMDD. This narrative review synthesizes the current literature on behavioral and physiological correlates of PMDD suitable for remote monitoring during the menstrual cycle. The reliable measurement of heart rate variability (HRV), sleep, and physical activity, with existing wearable technology, suggests the potential of a remote monitoring paradigm in PMDD and other depressive disorders.

    Keywords: PMDD1, PMS2, remote monitoring3, sleep4, HRV5, physical activity6

    Received: 14 Jun 2024; Accepted: 01 Oct 2024.

    Copyright: © 2024 Brown, Bondy, Dichter, Prim and Schiller. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Robin Brown, Department of Psychology and Neuroscience, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, 27599-3270, North Carolina, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.