OBJECTIVE: The American Psychiatric Association's DSM-IV Work Group on
Late Luteal Phase Dysphoric Disorder (LLPDD) reanalyzed existing data from
prospective, daily symptom ratings to evaluate the DSM-III-R criteria for
LLPDD. The objectives were to 1) evaluate the individual symptoms presently
required for the diagnosis and other symptoms, 2) determine the proportion
of treatment-seeking women who meet the LLPDD criteria, and 3) explore the
association between LLPDD and other mental disorders. METHOD: Data from
over 1,000 women seeking evaluation for premenstrual complaints at five
U.S. sites were examined. The data from 670 of these women were
sufficiently complete to warrant evaluation by four different methods of
assessing symptom change. RESULTS: Depending on the assessment method used,
14% to 45% of the women met the criteria for LLPDD. The current DSM-III-R
symptoms were classified as positive for 7% to 54% of the women. Each of
these symptoms was significantly more common among women with LLPDD
regardless of the assessment method used. Five symptoms not presently
included were also significantly more common. Women who had had mental
disorders in the past, but not present, showed a significantly greater, but
very small, relative risk of LLPDD. CONCLUSIONS: The variability in the
frequency of LLPDD diagnosis according to method of assessing symptom
change underscores the need for a uniform assessment method. The five
additional symptoms with frequencies comparable to those of the DSM-III-R
symptoms should be studied further for possible inclusion in the
criteria.
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