Prospective assessment of late-luteal phase dysphoric disorder

Abstract

This investigation evaluated a method for the prospective assessment of the symptoms of premenstrual syndrome (PMS). The American Psychiatric Association has proposed a diagnostic category for PMS in the DSM-III-R entitled late-luteal phase dysphoric disorder (LLDD). The criteria for this disorder include prospective documentation of at least two “symptomatic cycles.” Two groups of women were studied, one group that met the DSM-III-R diagnostic criteria for LLDD and a comparison group that did not. Subjects recorded symptoms related to PMS for two menstrual cycles. A clinically significant worsening of symptoms was defined as a symptom increase during the premenstruum of greater than one standard deviation above normal. These effect sizes were then used to determine if the subject met the DSM-III-R criteria for prospective confirmation. Data analysis showed that although the LLDD group showed evidence for PMS in several symptom groups, only a minority (31%) met the requirement of prospective confirmation of significant PMS symptoms for the two cycles recorded. These results were discussed in terms of the need for prospective behavioral assessment of LLDD and the implications of these findings for past and future research.