Associação entre síndrome disfórica pré-menstrual, atenção, memória e aprendizagem de estudantes de medicina

Abstract

Premenstrual Dysphoric Syndrome (PMDS) constitutes extreme form of Premenstrual Syndrome characterized by a group of physical and psychiatric symptoms and manifested in the luteal phase of the menstrual cycle, lasting until the onset of menstruation. The objective was to investigate in the PMDS medical students of the Federal University of Ceará, Brazil, aspects related to attention, memory and cognitive assessment. Through descriptive and cross sectional study with quantitative and qualitative approaches, 50 students were divided into two groups: 15 (30%) in the Premenstrual Dysphoric Syndrome, syndrome group (SG) and 35 (70%) in the control group (CG). Individual assessments were conducted in pre and post menstrual period using instruments: Semi structures Interview; Diagnostic Criteria Questionnaire for Premenstrual Dysphoric Treatment; Menstrual Distress Questionnaire; Stroop Color-Word Test (SCWT); Trail Making Test (TMT); Prospective and Retrospective Memory Questionnaire (PRMQ), Wechsler Scale (Logical Memory I, Visual Reproduction, Verbal-digits and Visual-spatial), Mini-Mental State Examination (MMSE), and cognitive assessment by a resolution of a clinical case delivered by video clip. The study was approved by School-Maternity Assis Chateaubriand Ethics Committee (Protocol number 499.671).The results were analyzed with GraphPad Prism® software (version 5.0 for Windows). In the premenstrual period, the GS showed lower score of attention than that of the GC in the three subtests SCWT with difference in subtest 3 (GS=18.73±0.95s, GC= 16.58±0.66s, mean ± SEM, p=0.0136, Mann-Whitney test [the longer the test, the less the attention score]). On The Trail of the TMT, GS showed lower score of attention that the GC (GS=25.52±2.6s and GC=17.36±1.90s, mean±SEM, p=0.0024, Mann Whitney test). On PRMQ (self-administered questionnaire), the GS have reported better Memory Retrospective and Prospective memory that the GC (GC=37.8±1.8; GC=38.5±1.3; mean±SEM; p<0.0001, Mann Whitney test). However, during the premenstrual period, the GS showed lower performance in Immediate Memory Story A (GS=17.47±0.98, GC= 19.27±0.95, mean±SEM, p=0.2879; Mann Whitney test), as well as the Immediate Memory of History B (GS= 14.53±0.60; GC= 16.77±0.57, mean±SEM, p=0.0114, Mann Whitney test). There was no difference between two groups on the MMSE and the cognitive evaluation through the video clip. We conclude that GS students showed deficits on some tests of attention and memory in relation to GC, though the two groups were not significantly different in cognitive assessment.