Assessment of Anxiety and Depression in Adolescents with Primary Dysmenorrhea: a Case-control Study

Study Objective: To examine the relationship between primary dysmenorrhea and symptoms of depression and anxiety among adolescent female students in Tbilisi, Georgia.

Design: A case-control study.

Setting: Tbilisi, Georgia.

Participants: Four hundred twenty-four postmenarcheal girls aged 14-20 years (a subset of a larger study involving 2561 girls).

Methods: The data was gathered in 2011 by the use of a questionnaire prepared for the purpose of this study, completed anonymously. Menstrual pattern, depression and anxiety level were evaluated in both groups; continuous and categorical variables were compared by Pearson chi-square test. Depressive symptoms were determined by a self-reporting scale (Beck Depression Inventory); anxiety was determined using Taylor Manifest Anxiety Scale (TMAS) and Spielberger State-Trait Anxiety Inventory (STAI).

Main Outcome Measures: Differences in mental health between two groups.

Results: Patients with primary dysmenorrhea (PD) had significantly higher scores of depression than the control subjects: moderate depression, 15.9% in PD patients vs 6.2% in control subjects and severe depression, 1.8% vs 0% (P < .003, LR 0.001). High anxiety (TMAS) was also more prevalent in adolescents with primary dysmenorrhea (44% vs 9.9%; P < .001, LR < 0.001). STAI scores were also significantly higher in these patients than in healthy women (68.9% vs 25.0%; P < .001, LR < 0.001).

Conclusion: Primary dysmenorrhea is strongly linked with positive scores for depression and anxiety. Because of this association, attention should be given to effective mental health screening in these patients; psychological support may be necessary during their treatment and follow-up.