Orientador: Jaime Aparecido Cury / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-25T22:05:28Z (GMT). No. of bitstreams: 1 Queiroz_CelsoSilva_M.pdf: 4148499 bytes, checksum: a250fc32bc9b3c95e74bc4505b1ca920 (MD5) Previous issue date: 1999 / Resumo: O objetivo do trabalho foi avaliar a relação entre o estresse e a concentração dos compostos sulfurados voláteis (CSV) no hálito bucal. Para tanto, foram avaliadas duas condições estressantes: Estudo I - prova; Estudo II - tensão pré-menstrual (TPM). O Estudo I foi composto de 2 grupos: A e B. O grupo A (34 voluntários), foi subdividido em 18 voluntários com estresse e 16 voluntários sem estresse. As concentrações dos CSV e foram medidas 1 semana antes da prova, no dia e 1 semana após, através do monitor de sulfetos (Halimeter) e o fluxo salivar também foi mensurado. No grupo B (37 voluntários), além dessas análises foram mensurados o pH, "capacidade tampão", cálcio, fósforo e proteína na saliva. O Estudo II foi composto por 50 voluntárias: 27 mulheres sem TPM (controle) e 23 mulheres com TPM. As mensurações dos CSV e do fluxo salivar foram realizadas nos períodos não-menstrual, pré-menstrual e de menstruação. A análise estatística mostrou que tanto no Grupo A (n=34) quanto no Grupo B (n=37) a concentração dos CSV no dia da prova foi maior (p<0,05) enquanto que a taxa de fluxo salivar foi menor (p<0,05). Os voluntários com estresse (n=18) e sem estresse (n=16) também apresentaram maiores concentrações de CSV no dia da prova (p<0,05), enquanto o fluxo salivar foi menor somente nos voluntários não estressados (p<0,05). A análise bioquímica da saliva do Grupo B revelou - que o pH foi menor no dia da prova (p<0,05), e as demais análises não foram diferentes (p>0,05). No Estudo II, as voluntárias sem TPM (n=26) apresentaram maior concentração dos CSV no período menstrual (p<0,05). Enquanto nas voluntárias com TPM (n=23) a concentração dos CSV foi maior (p<0,05) nos períodos menstrual e pré-menstrual. Já o fluxo salivar não mostrou diferenças (p>0,05). Os resultados sugerem que o estresse é um fator pré-disponente da halitose, cujo mecanismo não pode ser explicado somente pela diminuição do fluxo salivar / Abstract:The aim of study was to evaluate the relationship between stress and volatile sulfur compounds (VSC) present in mouth air. Thus, two stressfull conditions were evaluated: Study 1- examination; Study II - premenstrual syndrome (PMS). Study I was composed of 2 groups: A and B. Group A (34 volunteers), was divided in 18 volunteers with stress and 16 volunteers without stress. VSC concentrations were measured a week before, on day and a week after the exam using a sulfide monitor (Halimeter) and the salivary flow was measured. In group B (37 volunteers), others analyisis as pH, "buffer capacity", proteins, calcium and phosphorus, in saliva were performed. In study II, fifty women were selected: 27 women without PMS symptoms (control group) and 23 women with PMS symptoms. The measurements were performed during non-menstrual, PMS and menstrual periods. The statistical results showed in both groups A and B an increase of VSC concentration on the exam day (p<0.05) and the salivary flow was lower (p<0.05). Volunteers with stress (n=18) and without stress (n=16), presented higher VSC concentration on the exam (p<0.05), but there was statistical diferences in the salivary flow rate only in the volunteers without stress (p<0.05). The biochemistry analisys of the saliva in group B showed that pH was lower on the exam day (p<0.05), and others analisys were not statistical differences (p>0.05). In study II, the volunteers without PMS symptoms (n=26) presented higher VSC concentration in the menstrual period (p<0.05). Volunteers with PMS (h=23) showed a greater VSC concentration in both menstrual and PMS periods (p<0.05). Salivary flow rate was not statistically different (p>0.05). The results suggest that stressful conditions can be a predisposing factor for bad breath, and the mechanism cannot be explained only by the decrease of the salivary flow / Mestrado / Fisiologia Oral / Mestre em Odontologia

Energy intake (EI) and energy expenditure (EE) across the menstrual cycle (MC), while considering body adiposity, have not been previously evaluated in the same individuals. This study mainly examined the variations in energy balance (EB) across MC. Seventeen women (Body fat-DXA:28.5%) participated in three identical sessions during distinct phases of the MC: Early-follicular, Late-follicular/ovulation and Mid-luteal (confirmed by basal temperature and sex-steroid hormones). EI, resting metabolic rate (RMR), physical-activity EE (PAEE), severity of PMS, leptin and relative-reinforcing value (RRV) of preferred foods were measured during each phase. No differences in body fat, EI, RMR, PAEE, leptin and RRV of food were noted across MC. Trends were noted in preferred snack (p=0.06) and combined snack/fruit (p=0.06) intakes, while differences were noted in severity of PMS (p<0.05) across phases. Changes in EB across the MC were not noted. PMS was more severe, and preferred snack and combined snack/fruit intakes were slightly higher during mid-luteal phase.

Bakgrund: Cirka 75% av alla fertila kvinnor påverkas i varierande grad av premenstruella symtom. 15–20% har uttalad PMS medan 2–5% drabbas av den allvarligare varianten PMDS. De vanligaste symtomen är ilska, irritabilitet, ångest, ökad svullnadskänsla i kroppen, ömhet i brösten, huvudvärk, led-/muskelvärk och viktökning. Syfte: Syftet med litteraturstudien var att undersöka kvinnors erfarenheter av att leva med PMS och PMDS. Metod: Examensarbetet utfördes som en litteraturstudie med kvalitativ studiedesign där tio vetenskapliga artiklar sammanställdes för att kunna svara på det valda syftet. Resultat: För vissa kvinnor innebar premenstruella besvär år av månatligt lidande, för andra var det ett tecken på att vara en frisk kvinna. Kvinnorna hade olika copingstrategier för att få vardagen att fungera, de vanligaste var egen tid och att praktisera självövervakning. Många upplevde en negativ samhällelig bild av PMS och hur den premenstruella kvinnan uppfattades, dessa normer och ideal påvisades ha en skadlig inverkan på den egen självbilden och hur kvinnorna upplevde sina premenstruella besvär. Jean Watson (1985) belyser vikten av att sjuksköterskan ingjuter tro och hopp i patienten inför den situation den befinner sig i. På så vis kan sjuksköterskan bidra till beteende- och attitydförändringar. Slutsats: Kvinnorna upplever en samhällelig okunskap om PMS och PMDS som påverkar i vilken utsträckning de vågar tala om sina besvär. Okunskapen leder till att kvinnorna inte får det stöd och den hjälp de behöver för att klara vardagen, något som har direkt inverkan på livskvaliteten. Ökad medvetenhet och kunskap hos sjuksköterskan är grundläggande för att kunna ge adekvat och personcentrerad vård till dessa kvinnor. / Background: Approximately 75% of all women of childbearing age are affected by premenstrual symptoms. 15–20% have more distinct PMS, while 2–5% suffer from the more severe version PMDD. The most common symptoms are anger, irritability, anxiety, increased bloating, soreness in the breasts, headaches, joint/muscle pain and weight gain. Aim: The aim of the literature study was to investigate women's experiences of living with PMS and PMDD. Method: The thesis was carried out as a literature study with a qualitative study design. Ten scientific articles were compiled in order to answer the aim of the study. Results: For some women, PMS can mean years of monthly suffering, for others it's a sign of being a healthy woman. Women witnessed having to resort to different coping strategies to make everyday life work, the most common were personal time and self-monitoring. Many women experienced a negative societal image of PMS and how the premenstrual woman was perceived, these norms and ideals have been shown to have a harmful impact on their self-image and how they experience their premenstrual distress. Jean Watson (1985) highlights the importance of the nurse instilling faith and hope in the patient before the situation they find themselves in. In this way, the nurse can contribute to behavioral and attitudinal changes. Conclusion: Women feel that there is a societal ignorance that affects the extent to which they are comfortable speaking about their distress. This means that women do not receive the support and help they need to cope with everyday life, something that has a direct impact on their quality of life. Increased awareness and knowledge is fundamental in order for the nurse to provide adequate and person centered care for these women.

Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

Inledning Generella riktlinjer för kost och hälsa har historiskt utformats utifrån forskning på män, vilket resulterat i att kvinnor i fertil ålder ofta blivit missförstådda, misstolkade och felbehandlade. Låggradig inflammation, snabbmat och den moderna livsstilen, misstänks vara grund för flera sjukdomar vilka övervägande drabbar kvinnor. Syftet med studien var en kartläggning och kritisk granskning av forskning på hälsa och ohälsa hos kvinnor i fertil ålder relaterad till kosthållning. Metod Studien är en litteraturöversikt över tio artiklar fokuserade på kvinnor i fertil ålders hälsa och ohälsa i relation till kost. Artiklarna har systematiskt analyserats och sammanfattats. Resultat Resultatet visade att kvinnors fertilitet, inträdet av klimakteriet, premenstruella besvär och sjukdomar tycks relaterade till fysiska obalanser och inflammation samt påverkas av kostval. Gula och gröna grönsaker och frukter, fibrer, vegetabiliskt protein och antiinflammatorisk kost var att föredra för goda hälsoeffekter. Diskussion Kostens betydelse för fertilitet och hälsa hos kvinnor i fertil ålder var tydlig och sammanlagda effekter av nutrienter i kost verkar överträffa enskilda tillskott. Kunskapsspridning och mer forskning är essentiell för att stärka gruppens hälsa, främja empowerment samt möjliggöra goda bio-psyko-sociala effekter. / Introduction General diet and health guidelines have historically been designed based on research on men, with the result that women of childbearing age have often been misunderstood, misinterpreted and mistreated. Low-grade inflammation, fast food and modern lifestyle, is thought to be the basis of several diseases predominantly afflicted by women. The purpose of the study was a survey and critical review of health and ill health research in women of childbearing age related to dietary choices. Method The study is a literature review of ten articles focusing on health and ill health of women at child bearing age in relation to diet. The articles have been systematically analyzed and summarized. Results The results showed that women's fertility, the onset of menopause, premenstrual disorders and diseases appear to be related to physical imbalances and inflammation and were affected by dietary choices. Yellow and green vegetables and fruits, fiber, vegetable protein and an antiinflammatory diet displayed extra beneficial health effects. Discussion The importance of diet for fertility and health in women of childbearing age was clear and the combined effects of nutrients in diet appear to exceed individual supplements. Knowledge dissemination as well as research is essential for strengthening the group's health, promoting empowerment as well as make room for good bio-psycho-social effects.

Introduktion: Många kvinnor påverkas negativt av fysiska och psykiska besvär under sin menstruationscykel. Det råder idag stor kunskapsbrist om hur subkliniska menstruella besvär som kraftig menstruationssmärta, riklig menstruationsblödning, premenstruellt syndrom, premenstruellt dysforiskt syndrom, oregelbunden menstruation och menstruationsbortfall kan lindras utan att använda läkemedel. Fysisk aktivitet och kost har visats ge stora hälsoeffekter vid många sjukdomar och besvär och därför var syftet att undersöka om det även ger positiva hälsoeffekter vid menstruella besvär. Syfte: Syftet med litteraturstudien var att studera om fysisk aktivitet och kost kan minska fysiska och psykiska subkliniska menstruella besvär och därigenom ge ökat välmående. Metod: Sökt i Pubmed med sökorden subkliniska besvär i relation till fysisk aktivitet respektive kost hos fertila tränade och otränade kvinnor utan inverkan av hormonella preventivmedel. Resultat: Studien har visat vissa belägg för att fysisk aktivitet och kost kan lindra några subkliniska menstruella besvär. Premenstruellt syndrom (PMS) kan främst lindras genom lugna, meditativa aktiviteter. Vidare sågs god effekt på PMS av mindre men fler måltider med komplexa kolhydrater, samt intag av vitaminer och mineraler. Yoga har även visats minska menstruationssmärta, och allmän fysisk aktivitet har visat antydan till att förbättra menstruationens regelbundenhet. För att undvika oregelbunden menstruation eller menstruationsuppehåll behövs adekvat energiintag. Övriga subkliniska menstruella besvär saknade tydliga rekommendationer. Konklusion: Studien har visat att fysisk aktivitet och kost kan ha positiva effekter på vissa menstruella subkliniska besvär. För kvinnor med PMS verkar lugna, meditativa former av fysisk aktivitet kunna lindra syndromet. Yoga och fysisk aktivitet har även visats minska dysmenorré. Tillräckligt energiintag är essentiellt för att undvika oregelbunden och utebliven menstruation. Ytterligare studier behövs inom området för att säkerställa resultat och ge generella rekommendationer. / Background: Many women experience physical and psychological symptoms during their menstrual cycle. Research is scarce about how to ease subclinical menstrual disorders like dysmenorrhea, menorrhagia, premenstrual syndrome, premenstrual dysphoric syndrome, oligomenorrhea and amenorrhea without using medicines. Physical activity and diet is proved to have positive effects on several diseases and we therefore wanted to see if positive effects also could be seen on subclinical menstrual disorders. Aim: The aim of this study was to investigate if physical activity and diet could reduce physical and psychological subclinical menstrual disorders and lead to a better wellbeing. Method: Searching for subclinical menstrual disorders in relation to physical activity and diet in fertile, active and inactive women without the use of hormonal contraceptives was done using Pubmed. Results: The study has shown that physical activity and diet could reduce some of the problems associated with subclinical menstrual disorders. Premenstrual syndrome (PMS) could be eased through calm, meditative activities. Positive effects could be seen when eating more often but smaller meals containing complex carbohydrates and by taking additional vitamins and minerals. Yoga has been proved to reduce menstrual pain and there’s also an indication that physical activity could improve the regularity of the menstrual cycle. Adequate energy intake is needed to avoid oligomenorrhea and amenorrhea. No clear recommendations were found for the remaining subclinical menstrual disorders. Conclusion: The study has shown that physical activity and diet have positive effects on some subclinical menstrual disorders. Symptoms of PMS could be eased by calm, meditative activities. Yoga and physical activity have been shown to reduce dysmenorrhea. Adequate energy intake is essential to avoid oligomenorrhea and amenorrhea. Further research is needed to give general recommendations.

Introdução: O diagnóstico da Síndrome Pré-menstrual (SPM) é um desafio. O uso de questionários estruturados está bem estabelecido, e a ferramenta mais aceita é o DRSP, um questionário prospectivo auto preenchido por ao menos dois meses. O PSST é um questionário retrospectivo de autoaplicação, preenchido em um único momento. Objetivo: comparar estes dois instrumentos (PSST e DRSP) para o diagnóstico da SPM. Método: Um estudo transversal com 127 mulheres entre 20 a 45 anos com queixas de SPM. As mulheres foram avaliadas quanto ao peso, altura, Índice de Massa Corporal (IMC). Após exclusão de casos de depressão através do Prime-MD, as pacientes completaram o PSST e foram orientadas a preencherem o DRSP durante dois meses. A concordância entre os dois questionários foi avaliado pelo cálculo de Kappa (k) e valores do coeficiente PABAK. Resultados: Do total de mulheres que atenderam ao chamado, 282 (74%) preencheram os critérios de elegibilidade e responderam o PSST. Entre estas 282 mulheres, somente 127 (45%) completaram o questionário diário (DRSP) por dois ciclos. O percentual das mulheres com diagnóstico de SPM através do DRSP foi de 74,8%, e pelo PSST foi 41,7%. O percentual das mulheres com diagnóstico de TDPM pelo DRSP foi de 3,9%, e pelo PSST foi de 34,6%. Assim, verificou-se uma maior prevalência de SPM com o DRSP do que com o PSST. De outra parte a TDPM foi mais dignosticada pelo PSST do que com o DRSP. O número de pacientes consideradas “normais” foi semelhante com os dois instrumentos. Na avaliação entre os dois instrumentos verificou-se não haver nenhuma concordância (Kappa = 0,12) nos resultados do diagnóstico de SPM e TDPM (Coeficiente Pabak resultou = 0,39). Para a trigem de SPM/TDPM o PSST tem uma sensibilidade de 79% e especificidade de 33,3%. Conclusão: O PSST deve ser considerado como uma ferramenta de triagem diagnóstica. Conclui-se que os casos SPM/TDPM do PSST devem ser sempre melhor avaliados pelo DRSP. / Background: The diagnosis of Premenstrual Syndrome (PMS) is a challenge. The use of structured questionnaires is well established and the most accepted is the DRSP, a prospectively self-administered questionnaire that needs two months at least to be completed. The PSST is a retrospective self-scale questionnaire, filled at a single time. Aim: To compare these two instruments (PSST and DRSP) to diagnosis PMS. Methods: A cross-sectional study with 127 women between 20 and 45 years with PMS complaints. The women were evaluated about weight, high, Body Mass Index (BMI). After the exclusion of depression by the Prime-MD Questionnaire, the PSST was completed and the women were oriented to complete the DRSP for two months. The agreement between the two questionnaires was assessed by calculating the Kappa (k) and PABAK values. Results: 282 (74% of all the women) women met eligibility criteria and answered the PSST. Only 127 (45% of the 282 women) completed the daily questionnaire (DRSP) for two cycles. The percentual of women with PMS diagnosis by the DRSP was 74.8%, and by PSST was 41.7%. The percentual of women with PMDD diagnosis by the DRSP was 3.9%, and by the PSST was 34.6%. The number of patients considered “normal” (with the symptoms above the necessary for the diagnostic the PMS) was similar with both questionnaires. We found no agreement between the two instruments (Kappa = 0.12) in the diagnosis of PMS and PMDD (Pabak coefficient keep this result = 0.39). For screening PMS/PMDD the PSST has a sensitivity of 79% and a specificity 33.3%. Conclusion: The PSST should be considered as diagnostic screening tool. We concluded that positive PMD/PMDD cases of PSST should be ever better evaluated by DRSP.

M.A. / Irritable bowel syndrome [IBS] has been described as a chronic relapsing condition, characterised by a change in bowel habit and abdominal pain, that cannot be explained by an organic disease. Some research indicates that IBS may be psychogenic in origin, however, the aetiology of this complex syndrome is still unclear. Some researchers have postulated that IBS is primarily a motility disorder of the gut, while others have indicated that the symptoms of IBS are mediated by the central nervous system. Thus it is not surprising that the care of patients with IBS poses a particular challenge to physicians, especially because of its biologic and symptomatic heterogeneity and, particularly for patients with refractory symptoms, its association with psychological disturbances. The literature study indicates that there that there may be a possible connection between the ingestive disorders, the menstrual cycle fluctuations associated with premenstrual dysphoric disorder and IBS. All three of these disorders also appear to be mediated, to some extent, by the neurotransmitter serotonin. In terms of these suggested correlations one of the aims of this study was to determine whether blood-serotonin levels significantly influence the symptomatology of IBS. Extensive literature exists documenting the potential role that serotonin plays in gastrointestinal functioning. However, none of the existing studies refer specifically to blood-serotonin levels. Thus the present study attempted to address this problem. A second aim of the present study was to determine the possible serotonergic connection in the ingestive disorders and premenstrual dysphoric disorder in women with IBS. All the subjects were required to go for a blood test in order to determine whether their serotonin levels were low, normal, or high. In addition, three self-report questionnaires were used in this investigation. The Irritable Bowel Syndrome Client Questionnaire; The Eating Disorder Inventory -2, of which four subscales out of 11 subscales were included, namely the Drive for Thinness, Bulimia, Body Dissatisfaction and Introceptive Awareness subscales; and the Premenstrual Assessment Form, of which six subscales out of 18 were included, namely Endogenous Depressive Features, Atypical Depressive Features, Signs of water Retention, General Physical Discomfort, Autonomic Physical Changes and Miscellaneous Physical Changes. In order to address the above mentioned aims, research was conducted at the Research and Counselling Centre for Psychogastroenterology at the Rand Afrikaans University. The Research and Counselling Centre for Psychogastroenterology is a facility developed to investigate the psychological constituents of IBS. Researchers at the centre are aiming to explore the multidimensional components of IBS with the purpose of gaining some understanding into the development and maintenance of this syndrome. A variety of topics are being investigated at the Research and Counselling Centre for Psychogastroenterology, including the role that stress, depression and coping styles play in IBS. Initially a sample group of (N = 60) women with IBS were selected for this research from a population of South Africans who were referred from gastroenterologists and general practitioners to the Centre for Gastroenterology at the Rand Afrikaans University. A number of women (N = 40) without IBS, from the north eastern suburbs of Johannesburg, were also asked to participate in this study in order to compile the comparison group.

El objetivo del presente estudio fue analizar las propiedades psicométricas de la Escala de Síndrome Premenstrual (ESPM) en una muestra de 461 estudiantes universitarias de pregrado de cuatro universidades privadas de Lima Metropolitana. El rango de edades de la muestra fue de entre los 16 a 27 años (M = 19.70, DE = 1.84). Los instrumentos aplicados fueron la ESPM, la Escala de Ansiedad de Zung (EAZ) y la Escala de Depresión de Zung (EDZ). Como evidencia de validez basada en la estructura interna, se realizó un análisis factorial exploratorio (AFE, n = 230) teniendo como resultado una estructura de nueve factores relacionados que explicaron el 56.35% de la varianza total considerando 41 de los 44 ítems originales. Luego se realizó un análisis factorial confirmatorio (AFC, n = 231) para evaluar el ajuste del modelo obtenido en el AFE, en el cual se obtuvieron adecuados índices de bondad de ajuste (χ2 = 1168.49; χ2/gl = 1.79; CFI = .90; RMSEA = .06; SRMR = .06), con la especificación de tres pares de errores correlacionados y la eliminación de dos ítems adicionales, resultando una estructura factorial final de 39 ítems. Los coeficientes de confiabilidad omega oscilaron entre .72 y .90. Como evidencia de validez convergente, se encontraron relaciones positivas y estadísticamente significativas entre las nueve dimensiones de la ESPM y las medidas de ansiedad y depresión. Se concluye que la ESPM y sus puntuaciones derivadas son una medida válida y fiable para evaluar el síndrome premenstrual en la población evaluada. / The present study aimed to analyze the psychometric properties (evidence of validity and reliability) of the Premenstrual Syndrome Scale (PMSS) in a sample of 461 undergraduate university students from four private universities in Lima. The age range’s sample was between 16 to 27 years old (M = 19.70, SD = 1.84). The tests applied were the Premenstrual Syndrome Scale (PMSS), the Zung Anxiety Scale (ZAS), and the Zung Depression Scale (ZDS). As evidence of validity related to internal structure, an exploratory factor analysis (EFA, n = 230) was performed, resulting in a structure on nine related factors that explained 56.35% of the total variance considering 41 of the 44 original items. Then a confirmatory factor analysis (CFA, n = 231) was performed in order to evaluate the fit of the model obtained in the CFA, in which adequate goodness fir indexes were obtained (χ2 = 1168.49; χ2/gl = 1.79; CFI = .90; RMSEA = .06; SRMR = .06). To obtain these indexes, three pair of correlated errors had to be specified and two additional items were eliminated, resulting in a thirty-nine items structure. The omega reliability coefficients ranged from .72 and .90. In addition, as evidence of convergent validity statistically positive relationships were found significant among the nine dimensions of the PMSS, anxiety and depression measures. It is concluded that the PMSS and its derived scores are a valid and reliable measure to evaluate premenstrual syndrome in this sample. / Tesis