title: Criteria for premenstrual dysphoric disorder: secondary analyses of relevant data sets.
abstract: BACKGROUND
  There is substantial information that premenstrual dysphoric disorder (PMDD) is a clinically significant disorder with biological underpinnings that differ from other psychiatric disorders. However, data regarding the symptoms noted in DSM-IV and timing of their expression in the menstrual cycle have had little empirical support.
  
  
  OBJECTIVE
  To provide evidence informing the definitional criteria for PMDD.
  
  
  METHODS
  Prospective surveys.
  
  
  METHODS
  General community and clinical settings.
  
  
  METHODS
  Two cohorts that included a representative sample and a self-identified treatment-seeking cohort. Main Outcome Measure  Daily ratings of perimenstrual symptoms and functioning.
  
  
  RESULTS
  Mood and physical symptoms were most severe and were accompanied by impairment in the 4 days before through the first 2 days of menses for the self-identified group and in the 3 days before through the first 3 days of menses in the community sample. The most problematic symptoms endorsed were those listed in DSM-IV, but depressed mood was less frequent than other affective symptoms. In the combined sample, 4 or more symptoms was the optimal cutoff point for maximizing both sensitivity and specificity when predicting impairment.
  
  
  CONCLUSIONS
  This is informative for DSM-5 in that the most symptomatic period typically includes the few days before through the first 3 days of menses rather than only the premenstrual phase. Further, we validated the salience of PMDD symptoms included in DSM-IV. Although the number of symptoms most associated with distress and impairment differed between the 2 cohorts, results from the combined cohort suggest that 4 symptoms are linked with impairment from PMDD symptoms.
authors.affiliation: Department of Psychiatry, Rush University Medical Center, Chicago, IL 60612, USA. ann_hartlage@rush.edu
authors.forename: S Ann
authors.initials: SA
authors.lastname: Hartlage
authors.forename: Sally
authors.initials: S
authors.lastname: Freels
authors.forename: Nathan
authors.initials: N
authors.lastname: Gotman
authors.forename: Kimberly
authors.initials: K
authors.lastname: Yonkers
mesh_terms: D000328:Adult; D000339:Affect; D005260:Female; D006801:Humans; D011293:Premenstrual Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D011446:Prospective Studies; D012720:Severity of Illness Index