Premenstrual Dysphoric Disorder

Prevalence

• 1.8% for women whose symptoms meet the full criteria without functional impairment.

• 1.3% for women whose symptoms meet the current criteria with functional impairment and without co-occurring symptoms from another mental disorder.

Symptoms

• One (or more) of the following symptoms must be present:

  1. Marked affective lability (e.g., mood swings: feeling suddenly sad or tearful, or increased sensitivity to rejection).

  2. Marked irritability or anger or increased interpersonal conflicts.

  3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.

  4. Marked anxiety, tension, and/or feelings of being keyed up or on edge.

• One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with the symptoms listed above:

  1. Decreased interest in usual activities.

  2. Subjective difficulty in concentration.

  3. Lethargy, easy fatigability, or marked lack of energy.

  4. Marked change in appetite; overeating; or specific food cravings.

  5. Hypersomnia or insomnia.

  6. A sense of being overwhelmed or out of control.

  7. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.

• The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others.

• The disturbance is not merely an exacerbation of the symptoms of another disorder.

• The symptoms are not attributable to the physiological effects of a substance or another medical condition.