Investigation of the effect of childhood traumatic experiences on self-harming behavior, suicide attempt and sexual function in patients diagnosed with premenstruel dysforic disorder and premenstruel syndrome

Objective: Premenstrual symptoms are frequently seen in women of childbearing age. In addition, the effects of these symptoms on the quality of life and functionality of the individual are examined as premenstrual syndrome and premenstrual dysphoric disorder according to their severity and characteristics. The psychopathophysiology of premenstrual disorders is broadly evaluated in a biopsychosocial framework and its etiology is examined in neurobiological, genetic, psychological and sociocultural fields. In support of this, some studies have indicated that patients with premenstrual disorders have traumatic childhood experiences. There are studies reporting suicide, intentional self-harm and sexual dysfunction in patients with premenstrual disorders. Similarly, the relationship between childhood trauma and suicide, non-suicidal self-injury and sexual dysfunction has been reported in many studies. However, there is no study in the literature evaluating the relationships between these parameters in patients with premenstrual disorders. The aim of this study was to examine the relationship between the presence of childhood trauma on suicidal behavior, nonsuicidal self-injury and sexual functions in patients with premenstrual syndrome and premenstrual dysphoric disorder. Method: This study was carried out on 1 March 2020 – 31 December 2020 at Recep Tayyip Erdoğan University Gynecology and Obstetrics outpatient clinic. A total of 100 female cases, aged between 18-45 years, who had no psychiatric treatment history for the last 6 months, were diagnosed with premenstrual syndrome in the DSM-5 scale, had regular menstrual cycles and had menstrual cycles of 25-35 days, were included in present study. Cases with mental retardation, dementia, alcohol and substance abuse, posttraumatic stress disorder, menstrual irregularity, hormone or oral contraceptive therapy, anemia, endometriosis, hyperprolactinaemia, pregnant, breastfeeding, urogenital operation, and menopause were exluded. Sociodemographic and clinical data form, premenstrual syndrome rating scale (PMSS), childhood trauma scale (CTQ-28), intentional self-harm questionnaire XI (DSHI), and Arizona sexual experiences scale (ASEX) were applied to the patients. Data analyzes were performed with SPSS-20.0. Results: In this study, it was determined that patients with premenstrual disorders had a high rate of childhood traumatic experiences and it was seen that the presence of childhood trauma may be a risk factor for the development of premenstrual disorder. In addition, in the presence of childhood trauma, intentional self-harming behavior and sexual dysfunction were found to be significantly higher in patients with premenstrual disorders. However, in the presence of childhood trauma in patients with premenstrual disorder, sexual problems were found to increase as the severity of symptoms increased, while the same finding was not found in the group without childhood trauma. The relationship between the total and sub-dimensions of childhood trauma and the level of premenstrual disorder and suicide attempt could not be determined, but the total score of the childhood trauma scale was found to be significantly higher in the presence of a suicide attempt. Conclusion: In patients with premenstrual syndrome and premenstrual dysphoric disorder, there is a relationship between the presence of childhood trauma and intentional self-harming behavior, suicide and sexual problems. The presence of a childhood traumatic experience is a risk factor for the development of premenstrual disorder. The presence of concurrent childhood traumatic experiences in women with premenstrual disorders may change the course of the disease, treatment and therapy approaches. For this reason, it is important to question childhood traumatic experiences together with additional comorbid conditions in the first application and evaluation of women with premenstrual complaints. Keywords: Premenstrual Syndromes; Disorder, Premenstrual Dysphoric; Dysphoric Disorder, Premenstrual; Premenstrual Dysphoric Syndrome; Syndrome, Premenstrual Dysphoric; childhood maltreatment; childhood trauma; suicide; deliberate self-harm behavior, sexual disfunction