2002 International International Biennial Scientific Meeting

FEMALE-SPECIFIC IRRITABILITY: A NEW MEASURE

Leslie Born, Meir Steiner and Gideon Koren

Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada

lborn@stjosham.on.ca

Background: At times, irritability is the primary presenting complaint during pregnancy or postpartum, premenstrually, or in the perimenopause. Women who suffer from marked irritability report that their tension and anger are directed most often at their partner and children. Concerns related to the content of the existing self-rating measures denote that none stands as a reliable and valid state measure of irritability in women. Preliminary studies have shown gender differences in the experience and expression of irritable mood.

Objective: To generate items for a new clinical measure of irritability in women.

Methods: A self-administered questionnaire - comprised of (i) open-ended questions to elicit key words and/or descriptive phrasing that describe irritability, and (ii) items from existing self-rating irritability measures - was distributed to patients (premenstrual, antenatal, postnatal, perimenopausal) and to healthy women in the community. Subjects' spontaneous descriptions were analyzed using Nudist Nvivo, a qualitative software program. Responses to items of existing measures were analyzed using SPSS non-parametric statistical tests and discriminant function analysis.

Results: 121 questionnaires were analyzed qualitatively. The core symptoms of irritability include: annoyance, anger, tension, hostile behaviour, and sensitivity. 114 questionnaires were analyzed statistically, and 11 items from the existing self-rating measures of irritability distinguished healthy subjects from women in the patient groups. Following a discriminant function analysis, 10 items of irritability have been incorporated into the new measure.

Relevance: The potential impact of severe maternal irritability on the spousal relationship and children's emotional, behavioral and cognitive development reinforces the importance of timely assessment and appropriate treatment. A new scale for measuring severity of irritability will assist clinical decision-making.