Recognizing and treating premenstrual dysphoric disorder in the obstetric, gynecologic, and primary care practices.
The author's aim is to aid primary care physicians and obstetrician-gynecologists in correctly diagnosing and treating premenstrual dysphoric disorder (PMDD). The symptoms fluctuate markedly, but their timing is key. PMDD patients experience symptoms only during the luteal phase and will have a symptom-free interval after the menstrual flow and before ovulation. The author discusses self-report instruments, which are valuable tools for diagnosis when combined with the ICD-10 criteria for premenstrual syndrome (PMS) or the DSM-IV criteria for PMDD and the ruling out of medical and psychiatric conditions, such as diabetes, hypothyroidism, major depression, and dysthymia, that cause similar symptoms. Treatment strategies ranging from nonpharmacologic approaches such as dietary modification and aerobic exercise to pharmacologic interventions such as antidepressants, anxiolytics, and agents to suppress ovulation are examined.
Ling
F W
FW
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA.
D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D002064:Buserelin / Q000627:therapeutic use; D003613:Danazol / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D003937:Diagnosis, Differential; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006176:Gynecology; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008499:Medical Records; D009774:Obstetrics; D010060:Ovulation / Q000187:drug effects; D010818:Practice Patterns, Physicians'; D011293:Premenstrual Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D011320:Primary Health Care; D011364:Professional Practice; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D004965:Estrogen Antagonists; D016729:Leuprolide; D003613:Danazol; D002064:Buserelin