premenstrual%20dysphoric%20disorder
PREMENSTRUAL DYSPHORIC DISORDER
Premenstrual dysphoric disorder is a cyclical disorder presenting with distressing mood and behavioral symptoms that occur during the late luteal phase of the ovulatory cycle; it is a severe form of premenstrual syndrome.
It results in considerable impairment of the patient's personal functioning that occurs in approximately 5% of women of reproductive age.

Introduction

Premenstrual Syndrome (PMS)

  • PMS is a group of recurrent mild to moderate physical and/or emotional symptoms occurring during the late luteal phase of the ovulatory cycle that do not usually interfere with the patient’s usual level of function
    • Occurs in approximately 75% of women of reproductive age, among whom 20-50% report moderate to severe symptoms

Definition

Premenstrual Dysphoric Disorder (PMDD)

  • PMDD is a cyclical disorder presenting with distressing mood and behavioral symptoms that occur during the late luteal phase of the ovulatory cycle; it is a severe form of PMS
  • PMDD results in considerable impairment of the patient’s personal functioning
    • Occurs in approximately 5% of women of reproductive age

Underlying Medical and Psychiatric Disorders

The following medical conditions may mimic PMDD with premenstrual exacerbation:
  • Allergies
  • Anemia
  • Asthma
  • Autoimmune or collagen vascular disorders
  • Chronic fatigue syndrome
  • Endometriosis
  • Endocrine disorders [diabetes mellitus (DM), hypothyroidism]
  • Epilepsy
  • Hyperprolactinemia
  • Irritable bowel syndrome
  • Migraine
  • Panhypopituitarism
  • Polycystic ovarian disease

The following psychiatric conditions may mimic PMDD with premenstrual exacerbation:

  • Anxiety disorders
  • Bipolar disorder
  • Bulimia
  • Cyclothymic disorder
  • Depression
  • Dysthymic disorder
  • Posttraumatic stress disorder
  • Psychosocial (current victim of physical abuse or history of sexual abuse)
  • Panic disorder
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