Diagnostic Accuracy of Salivary Cortisol As a Marker of Premenstrual Syndrome Degrees in Adolescents
Siregar, Muhammad Fidel Ganis
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Aim. Psychoneuroendocrine may play a role in the pathogenesis of premenstrual syndrome. There is an increase in cortisol level which resulted from psychosocial stressors, especially in adolescent. The aim of this study was to determine if salivary cortisol levels in adolescent can be used to determine the degree of premenstrual syndrome severity. Method. This is a cross-sectional study and diagnostic tests performed in academy of midwifery in Medan since July 2011 to February 2012. Samples were 77 adolescent girls aged 17-21 years at the academy of midwifery who have experience premenstrual syndrome and has fulfilled the inclusion and exclusion criteria. L-MMPI (Lie-Minnesota Multiphasic Personality Inventory) Scale questionnaire were used to assess the honesty of subjects. Adrenal stress questionnaires were filled in 7 days prior to the next cycle after which saliva cortisol were measured using ELISA test. Severity degrees were assessed using the PSST (Premenstrual Symptoms Screening Tool) as a reference standard. Result. Salivary cortisol was significantly associated with PMS degrees (P<.022). Using a cut off value of 0.116 ug/dl, moderatesevere and mild cases of PMS had sensitivity, specificity, positive and negative predictive values of 95.35, 91.17, 93.18, and 93.94, and 8.86, 4.65, 6.82, and 6.06%, respectively. Conclusion. Salivary cortisol is significantly associated with psychosocial stressors and premenstrual syndrome degrees and is an accurate diagnostic tool for cases of moderate-severe PMS.