--- title: How do stress, anxiety, and depression relate to premenstrual symptoms? description: Stress was associated with most premenstrual symptoms, but anxiety and depression were not independently linked to premenstrual symptoms. url: https://niyora.com/research/papers/dass-21-stress-but-not-anxiety-or-depression-is-associated-with-premenstrual-2025/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - How do stress, anxiety, and depression relate to premenstrual symptoms? Cohort study, 2025 # How do stress, anxiety, and depression relate to premenstrual symptoms? Stress was associated with most premenstrual symptoms, but anxiety and depression were not independently linked to premenstrual symptoms. Early or limited evidence 847 women ## What they did 847 women filled out a questionnaire about premenstrual symptoms and the DASS-21 questionnaire (which measures stress, anxiety, and depression) between 2011 and 2021. Researchers looked at which premenstrual symptoms went along with stress, anxiety, and depression. ## What they found Eight of the eleven premenstrual symptoms were associated with stress, including loss of interest, difficulty concentrating, and sad mood. Anxiety and depression were not independently associated with most premenstrual symptoms. ## What it means for you This study shows that stress goes with premenstrual symptoms, but does not prove stress causes them. It could be that stress causes symptoms, symptoms cause stress, or they share a common cause. The main weakness is that it is a one-time measurement of people, not following them over time, so cause and effect cannot be determined. 847 Women in study 8 of 11 Premenstrual symptoms linked to stress ## About the study Original title DASS-21 Stress, but Not Anxiety or Depression, Is Associated with Premenstrual Stress Authors Turner JV, Alefsen Y, McLindon LA et al. Journal Journal of clinical medicine Year 2025 Study design Cohort study Participants 847 What was tested None Open access Yes Read the paper [doi.org/10.3390/jcm14248619](https://doi.org/10.3390/jcm14248619) Original abstract Background/Objectives: Most women experience premenstrual symptoms. We examined how the eleven DSM-5 premenstrual symptoms relate to concurrent indicators of psychological distress. Methods: In this retrospective cross-sectional study, 847 participants completed a premenstrual symptom checklist and the DASS-21 between 2011 and 2021. Associations between each DSM-5 premenstrual symptom and DASS-21 depression, anxiety, and stress scores were estimated using univariable and multivariable models, adjusting for the other two DASS-21 subscales and prespecified confounders. Results: Eight of the eleven premenstrual symptoms, loss of interest, impaired concentration, depressed mood ( p p Conclusions: In this sample, stress was the principal psychological correlate of multiple premenstrual symptoms. These findings indicate co-occurrence rather than causation: the cross-sectional design does not establish directionality, and the observed patterns are compatible with several possibilities (such as stress contributing to, resulting from, or sharing common determinants with premenstrual symptoms). The lack of independent associations with DASS-21 anxiety and depression suggests these symptoms are not merely concurrent expressions of acute anxiety or depressive states. Prospective longitudinal studies are needed to test causal pathways. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Anxiety and tension](https://niyora.com/research/topics/symptom-anxiety/)[Stress](https://niyora.com/research/topics/symptom-stress/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Cohort study, 2025 How common is PMS in Chinese teenage girls, and what factors are linked to it? Randomised trial, 2024 Does curcumin reduce depression, anxiety, and stress in women with PMS and dysmenorrhea? Review, 2003 How do menstrual cycle hormones affect the brain and cause mood disorders like PMDD? Survey study, 2026 What dietary, lifestyle, and psychological factors are associated with PMS in young women? Randomised trial, 2026 Does yoga or Pilates help manage PMS symptoms? Randomised trial, 2026 Does education about PMS symptoms help reduce pain and stress? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗