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Premenstrual dysphoric disorder: A new psychological entity

Graham Cope details this recently classified condition which is still poorly understood by clinicians

There is a newly classified psychological entity in women called Premenstrual Dysphoric Disorder (PMDD).1 It is characterized by intense mood swings and changes to cognitive fluctuations, accompanied by distressing mental and physical symptoms and it is the most severe form of the premenstrual syndrome (PMS).2

PMDD symptoms typically arise during the menstrual cycle after ovulation and gradually resolve after the onset of menstruation. The prevalence of this disorder is estimated at between 3-8% in the general female population and is a chronic and impairing disorder that significantly affects women’s quality of life and everyday functioning.2


The symptomatic disorder has been recognised for some time but only recently identified as an entity in its own right. Typically the symptoms include irritability, dysphoria (a feeling of unease or dissatisfaction with life), mood changes and anxiety, with significant alterations to appetite and sleep patterns. There is frequent difficulty with concentration, while there are physical manifestations such as breast tenderness or swelling, and headaches.1 The symptoms, typically, arise in the postovulatory period, abate by the end of the menses3 and culminate during the day before or first day of menstruation.4

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