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Back| Prospective assessment of symptoms recorded by the patient over 2-3 menstrual cycles. Five (or more) of the following symptoms must be present during the last week of the luteal phase and must disappear after menstruation begins, with at least one of the symptoms being 1, 2, 3, or 4; |
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| 1. Markedly depressed mood, feelings of worthlessness, hopelessness |
| 2. Marked anxiety, tension, feeling “on edge” or “restless” |
| 3. Emotional instability, such as sudden sadness, crying, or increased sensitivity to rejection |
| 4. Persistent and marked irritability or anger, or increased interpersonal conflicts |
| 5. Diminished interest in usual activities (e.g., work, school, friends, hobbies) |
| 6. Subjectively feeling difficulty concentrating |
| 7. Hypersomnia, fatigue, or marked lack of energy |
| 8. Marked change in appetite, binge eating, or specific food cravings |
| 9. Insomnia |
| 10. Subjectively feeling restless or out of control |
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11. Other physical symptoms, such as breast tenderness or swelling, headaches, joint or muscle pain, bloating, weight gain These disturbances must significantly interfere with work or school or daily social activities and relationships (e.g., avoidance of social activities, decreased productivity and efficiency in work or study) These disturbances are not merely exacerbations of another disorder (e.g., major depressive disorder, panic disorder, severe mood disorder, or personality disorder). |
Explanation
Requirements for diagnosing PMDD: presence of 5 out of the 11 symptoms listed in the table during the 3 consecutive menstrual cycles prior to menstruation, relief within 4 days of onset of menstruation, with a symptom-free period lasting until day 13 of the cycle; at least one of the 5 symptoms must be a mood symptom (such as irritability, mood swings, anxiety, or depression); multiple physical symptoms are assessed as one symptom.
