DIAGNOSIS
Diagnosis of PMDD is guided by the DSM-5 criteria, which include the following components
- Content (presence of specific symptoms)
- Cyclicity (premenstrual onset and postmenstrual resolution)
- Severity (significant distress)
- Chronicity (occurrence in the past year).15
DSM-5 has established seven criteria (labeled A-G) for a PMDD diagnosis.1 First and foremost, a woman must experience a minimum of five of the 11 listed symptoms, with a minimum of one symptom being related to mood, during most menstrual cycles over the previous 12 months (Criterion A).1 The symptoms must occur during the week before the onset of menses, must improve within a few days of onset of menses, and must resolve in the week following menses.1
Mood-related symptoms (outlined in Criterion B) include
1. Notable depressed mood, hopelessness, or self-deprecation
2. Notable tension and/or anxiety
3. Notable affective lability (eg, mood swings, sudden sadness, tearfulness, or increased sensitivity to rejection)
4. Notable anger or irritability or increased interpersonal conflicts.1
Somatic or functional symptoms associated with PMDD (Criterion C) include:
5. Low interest in common activities (eg, those related to friends, work, school, and/or hobbies)
6. Difficulty concentrating
7. Lethargy, fatigue, or increased lack of energy
8. Notable change in appetite
9. Insomnia or hypersomnia
10. Feeling overwhelmed or out of control
11. Physical symptoms, such as breast tenderness or swelling, joint or muscle pain, headache, weight gain, or bloating.1
Again, patients must report at least one symptom from Criterion B and at least one from Criterion C—but a minimum of five symptoms overall—to receive a diagnosis of PMDD.1
Continue to: Additionally, the symptoms must...