Premenstrual Dysphoric Disorder Flashcards
criteria A of PMDD
in the majority of menstrual cycles, at least FIVE symptoms must be present in the FINAL WEEK before the onset of menses, start to improve within a few days of the onset of menses and become minimal or absent in the week post-menses
criteria B of PMDD
ONE (or more) of the following symptoms must be present:
- marked AFFECTIVE LABILITY (i.e mood swings, feeling suddenly sad or tearful or increased sensitivity to rejection)
- marked irritability or anger or increased interpersonal conflicts
- marked depressed mood, feelings of hopelessness or self deprecating thoughts
- marked anxiety, tension and/or feelings of being keyed up or on edge
criterion C for PMDD
ONE (or more) of the following symptoms must additionally be present, to reach a total of FIVE symptoms when combined with symptoms from criterion B
- decreased interest in usual activities
- subjective difficulty in concentration
- lethargy, easy fatigability, or marked lack of energy
- marked change in appetite, overeating or specific food cravings
- hypersomnia or insomnia
- a sense of being overwhelmed or out of control
- physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating” or weight gain
how many symptoms must you have between criterion B or C to meet DSM criteria for PMDD
a total of FIVE
*the symptoms in criteria A-C must have been met for MOST menstrual cycles that occurred in the preceding year
criterion D for PMDD
the symptoms are associated with clinically significant distress or interference with work, school, usual social activities or relationships with others (i.e avoidance of social activities, decreased productivity and efficiency at work, school or home)
criterion E for PMDD
the disturbance is not merely an exacerbation of the symptoms of another disorder like MDD, panic disorder, PDD or a personality disorder (although it may co-occur with any of these disorders)
criterion F for PMDD
criterion A should be confirmed by prospective daily rating during at least TWO symptomatic cycles
criterion G for PMDD
the symptoms are not attributable to the physiological effects of a substance or another medical condition
what is the relationship between menstrual cycle and suicide risk
the premenstrual phase has been considered by some to be a risk period for suicide
have psychotic symptoms been described in relationship to the menstrual cycle
delusions and hallucinations have been described in the LATE LUTEAL phase of the menstrual cycle but are RARE
what is the 12 month prevalence of PMDD
between 1.8-5.8% of menstruating women
*estimates are substantially inflated if they are based on retrospective reports rather than prospective daily ratings
when does PMDD usually start? are there times that this may worsen?
can occur at any time after menarche
many individuals report that as they approach menopause the symptoms worsen–> ANECDOTAL
symptoms cease after menopause –> cyclical formone replacement can retrigger the re-expression of symptoms
list environmental risk factors for PMDD
stress
hx of interpersonal trauma
seasonal changes
sociocultural aspects of female sexual behaviour in general –> female gender role in particular
what is the heritability of the most stable component of premenstrual symptoms
about 50% (but this is for premenstrual symptoms. generally not PMDD specifically–the heritability of PMDD is not known)
name a course modifier for PMDD
women who use OCP may have fewer premenstrual complaints than do women who do not use OCP
