Psychological and cognitive symptom correlates of dysmenorrhoea severity in adolescents: a cross-sectional study of cognitive disengagement syndrome

Abstract Background Dysmenorrhoea may be associated with psychological and attention-related difficulties in adolescence. Cognitive disengagement syndrome (CDS), characterised by daydreaming and mental fogginess, overlaps with internalising symptoms, but its relationship with dysmenorrhoea is unclear. We examined whether CDS was related to menstrual pain beyond psychological distress. Methods This cross-sectional study included 205 girls aged 12–17 years from a child and adolescent psychiatry clinic. Menstrual pain intensity was measured on a 0–10 visual analogue scale (VAS). Adolescents and parents completed measures of CDS, attention-deficit and hyperactivity/impulsivity symptoms, and executive functioning; adolescents completed the Brief Symptom Inventory (BSI). One item assessed everyday-life impact. Analyses used Spearman correlations, non-parametric comparisons, hierarchical linear regression, and binary logistic regression; bivariate p -values were adjusted for the false discovery rate ( q ). Results Menstrual pain intensity showed small correlations with adolescent-reported CDS (ρ = 0.21), attention-deficit (ρ = 0.17), hyperactivity/impulsivity (ρ = 0.18), and all five BSI subscales (ρ = 0.16–0.26; all q < 0.05), but not with executive functioning ( n = 167) or any parent-reported measure. After adjustment for age and body mass index, CDS was associated with pain intensity ( B = 0.022, 95% CI 0.005–0.039); the association was not evident after adding psychological distress ( B = − 0.004, 95% CI − 0.030 to 0.023). Psychological distress was associated with higher pain intensity ( B = 0.014, 95% CI 0.003–0.025), and the model explained 8.9% of the variance. 112 adolescents (54.6%) reported an appreciable adverse impact on everyday life. In the fully adjusted complete-case model ( n = 196; 106 events), greater pain intensity (OR 1.82 per VAS point, 95% CI 1.51–2.25) and lower body mass index (OR 0.83 per kg/m² increase, 95% CI 0.75–0.91) were associated with this outcome; CDS, psychological distress, and sleep problems were not statistically significant. Conclusions In this psychiatric outpatient sample, menstrual pain co-occurred with small elevations in adolescent-reported CDS, attention-related symptoms, and psychological distress; no parent-reported associations were found. CDS showed no additional association with pain after adjustment for psychological distress. These cross-sectional findings support asking adolescents directly about menstrual pain, but cannot establish causality or temporal direction.