Article: PDF OnlyPremenstrual Dysphoric Disorder An UpdateGold, Judith H. CM, MD, FRCPC, FRANZCP Author Information private practice, Halifax, Nova Scotia Journal of Psychiatric Practice: July 1999 - Volume 5 - Issue 4 - p 209-215 Buy Abstract The author, who chaired the Work Group for premenstrual dysphoric disorder (PMDD) for the DSM-IV Task Force, reviews what has been learned about PMDD since the publication of DSM-IV. She reviews data from studies published between 1994 and 1998 that used human subjects and the DSM-IV proposed research criteria for PMDD. Studies of the validity of the criteria have found that mood symptoms, including irritability, anxiety, and affective lability, were the most stable and discriminating of the symptoms, whereas somatic symptoms could be omitted from the criteria set without loss of validity. The author also reviews studies of the relationship between PMDD and other mood disorders, endocrine studies, and studies concerning the association of norepinephrine levels and PMDD. In each case, findings are still unclear and more research is needed. Treatment studies in PMDD done since the publication of DSM-IV have demonstrated the efficacy of ovariectomy, gonadal hormone releasing agonists, the selective serotonin reuptake inhibitors, and clomipramine. The author concludes that the literature suggests that PMDD should be considered as a differential diagnosis in all women who present with dysphoric mood complaints, but that it is important not to confuse PMDD with the premenstrual exacerbation of a pre-existing mood disorder. The literature suggests pharmacological treatment with an SSRI as the first choice. © 1999 by Lippincott Williams & Wilkins, Inc.