Recognizing and Treating Premenstrual Dysphoric Disorder in the Obstetric, Gynecologic, and Primary Care Practices
Frank W. Ling, MD
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The author’s aim is to aid primary care physicians and obstetrician-gynecologists in correctly diagnosing
and treating premenstrual dysphoric disorder (PMDD). The symptoms fluctuate markedly, but
their timing is key. PMDD patients experience symptoms only during the luteal phase and will have a
symptom-free interval after the menstrual flow and before ovulation. The author discusses self-report
instruments, which are valuable tools for diagnosis when combined with the ICD-10 criteria for premenstrual
syndrome (PMS) or the DSM-IV criteria for PMDD and the ruling out of medical and psychiatric
conditions, such as diabetes, hypothyroidism, major depression, and dysthymia, that cause
similar symptoms. Treatment strategies ranging from nonpharmacologic approaches such as dietary
modification and aerobic exercise to pharmacologic interventions such as antidepressants, anxiolytics,
and agents to suppress ovulation are examined.
J Clin Psychiatry 2000;61(suppl 12):9-16
© Copyright 2000 Physicians Postgraduate Press, Inc.
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