Mood Disorder History and Personality Assessment in Premenstrual Dysphoric Disorder
J Clin Psychiatry 2001;62:688-693
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Menstrually related dysphoria is
known to be associated with other affective disorders, notably
major depressive disorder and puerperal depression. The
relationship between premenstrual dysphoric disorder (PMDD) and
maladaptive personality disorders and traits, however, is less
established, at least in part because of the methodological and
nosologic difficulties in the diagnosis of both PMDD and
personality disorders. This study seeks to address this problem
to elucidate the relationship between PMDD, other affective
disturbances commonly experienced by women, and maladaptive
Method: Axis I and II disorders were examined
using standardized instruments and stringent diagnostic criteria
(DSM-IV and the International Personality Disorders Examination)
in 34 women with DSM-IV PMDD and 22 healthy women without severe
premenstrual mood changes.
Results: Seventy-seven percent of the PMDD group
had suffered from a past Axis I disorder in comparison with 17%
of the control group. Two thirds of the parous women with PMDD
had suffered from major depressive disorder in the puerperium.
Personality disorder diagnoses were not highly represented in
either group of women. The women with PMDD had significantly more
obsessional personality traits (p < .001) but not absolute
personality disorder diagnoses.
Conclusion: Obsessional symptoms are known to
cluster with the affective disorders and may reflect underlying
temperamental and biological vulnerability. This study provides
further evidence of the link between serotonergic dysregulation,
personality vulnerability, and mood changes related to the female