The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) specifies the possible symptoms of PMDD as: (1) affective lability (mood swings), (2) irritability or anger, (3) depressed mood, (4) anxiety or tension, (5) decreased interest in usual activities, (6) difficulty concentrating, (7) a sense of being overwhelmed or out of control, (8) change in appetite, overeating, or specific food cravings, (9) hypersomnia or insomnia, (10) fatigue, and (11) one physical symptom (for example, breast tenderness). PMDD diagnosis requires the presence of at least one affective symptom (symptoms 1–4) to reach the total of 5 required symptoms, which must be confirmed in a prospective manner for at least 2 menstrual cycles. In addition, the symptoms must be associated with clinically significant distress or interference with work, school, usual social activities, or relationship with others.
In accordance with DSM-5 criteria, PMDD diagnosis in the proposed study was be assessed prospectively by evaluating the participants’ daily symptom ratings using the DRSP scale [22 (link)] during two–three menstrual cycles. PMDD diagnosis was defined as a 30% or greater increase in 5 or more symptoms, one of which had to be affective, as well as functional impairment, between the luteal (day −7 to −1) and follicular (day 6 to 12) days relative to the range of the scale of each individual participant across the entire menstrual cycle [27 (link)]. PMDD participants defined using these criteria were found to have differential cellular [27 (link),28 (link)] and sex hormone processing [29 (link)], as well as unique transcriptional responses [30 (link)].
Of note, and in references to the discussion section, the diagnosis of premenstrual syndrome (PMS) requires a prospective assessment of symptomatology, with the presence of 1 to 4 symptoms and without the need that one of them must be affective.
In accordance with DSM-5 criteria, PMDD diagnosis in the proposed study was be assessed prospectively by evaluating the participants’ daily symptom ratings using the DRSP scale [22 (link)] during two–three menstrual cycles. PMDD diagnosis was defined as a 30% or greater increase in 5 or more symptoms, one of which had to be affective, as well as functional impairment, between the luteal (day −7 to −1) and follicular (day 6 to 12) days relative to the range of the scale of each individual participant across the entire menstrual cycle [27 (link)]. PMDD participants defined using these criteria were found to have differential cellular [27 (link),28 (link)] and sex hormone processing [29 (link)], as well as unique transcriptional responses [30 (link)].
Of note, and in references to the discussion section, the diagnosis of premenstrual syndrome (PMS) requires a prospective assessment of symptomatology, with the presence of 1 to 4 symptoms and without the need that one of them must be affective.
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