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A Diagnostic and Statistical Manual of Mental Disorders History of Premenstrual Dysphoric Disorder

Zachar, Peter PhD*; Kendler, Kenneth S. MD

The Journal of Nervous and Mental Disease: April 2014 - Volume 202 - Issue 4 - p 346–352
doi: 10.1097/NMD.0000000000000128
Original Articles

The proposals to include a menstruation-related mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R), and DSM-IV led to intense public and behind-the-scenes controversy. Although the controversies surrounding the DSM-5 revision were greater in number than the controversies of the earlier revisions, the DSM-5 proposal to include a menstruation-related mood disorder was not among them. Premenstrual dysphoric disorder was made an official disorder in the DSM-5 with no significant protest. To understand the factors that led to this change, we interviewed those psychiatrists and psychologists who were most involved in the DSM-IV revision. On the basis of these interviews, we offer a list of empirical and nonempirical considerations that led to the DSM-IV compromise and explore how key alterations in these considerations led to a different outcome for the DSM-5.

*Department of Psychology, Auburn University Montgomery, AL; and †Virginia Institute of Psychiatric and Behavioral Genetics, Department of Psychiatry and Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA.

Send reprint requests to Kenneth S. Kendler, MD, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, Box 980126, 800 E. Leigh St, Room 1-123, Richmond, VA 23298-0126. E-mail:

A longer version of this article will be published as a book chapter in Philosophical Issues in Psychiatry III: The Nature and Sources of Historical Change. Oxford, UK: Oxford University Press.

© 2014 by Lippincott Williams & Wilkins