Table 2:
Criteria for diagnosis of PMDD*
A. Symptoms begin 1 week before menses and resolve in the first few days after menses (over most menstrual cycles during the past 12 months)
B. One of the five symptoms must be one of the first four listed below:

1. Depressed mood with feelings of hopelessness
2. Anxiety or tension
3. Affective lability
4. Irritability and anger
5. Decreased interest in usual activities and social withdrawal
6. Lack of energy (fatigue)
7. Appetite changes (overeating/undereating)
8. Changes in sleep pattern (hypersomnia/insomnia)
9. Feeling out of control or overwhelmed
10. Difficulty with concentration
11. Somatic symptoms such as bloating, mastalgia, or headaches

C. Symptoms must be severe enough to interfere with work, school, usual activities, or interpersonal relationships
D. Symptoms may be superimposed on an underlying psychiatric disorder, although they should not be an exacerbation of another condition
E. Criteria A, B, C, and D must be confirmed by prospective daily charting for a minimum of two consecutive symptomatic menstrual cycles

*Modified from Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington, DC: American Psychiatric Association; 1994.

Copyright 2003 The Cleveland Clinic Foundation

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