Reply to Letter to the Editor "Association Between Premenstrual Syndrome and Depression"

Letter to the Editor

Sir: We appreciate the thoughtful and astute questions posed by Drs. Soares and Cohen. They correctly raise the possibility that women who display susceptibility to mood disturbance during the menstrual cycle might be vulnerable to depression during other periods of reproductive endocrine change. Although one of the patients (and none of the controls) had a history of postpartum depression, the Structured Clinical Interview for DSM-IV did not enable us to determine retrospectively the occurrence of postpartum blues. While the role of gonadal steroids in postpartum blues, a fairly ubiquitous phenomenon, has not been determined, we have recently shown that euthymic women with a history of postpartum depression will experience depression in association with gonadal steroid manipulations that are without effect in women lacking a history of postpartum depression, thus reinforcing the relevance of the first question raised by Drs. Soares and Cohen