How common are PMS and PMDD in teenagers, and can a new questionnaire measure their impact?

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are common conditions associated with significant impairment and distress across multiple domains of functioning, including academic and occupational settings. Although menstruation, and with it the potential onset of PMS or PMDD, typically begins in early adolescence, research in adolescent populations remains limited. Therefore, the present study was conducted to examine the prevalence of PMS and PMDD in German-speaking adolescents, and to evaluate the psychometric properties of the adolescent-adapted version of the Premenstrual Impact Questionnaire (PMS-I-Y). Methods: In this cross-sectional online study, 521 adolescents aged 14-18 years from Germany, Austria and Switzerland were recruited via Instagram. Premenstrual symptoms were assessed using the PMS-Q-Y. Participants meeting criteria for at least mild PMS completed the PMS-I-Y to assess symptom-related impairment. Severity classifications were based on operationalized questionnaire criteria derived from DSM-5 and PSST-A frameworks. Confirmatory and exploratory factor analyses were conducted to examine factorial validity. Convergent and discriminant validity were assessed using correlations with symptom severity and personality traits. Results: A substantial proportion of participants reported clinically relevant premenstrual burden, with 46.6% meeting criteria for moderate-to-severe PMS and 22.5% meeting criteria for PMDD. Factor-analytic results indicated a strong general factor of premenstrual impairment alongside psychological and functional components. Convergent validity was supported by strong associations with symptom severity (r = .65 - .75). Discriminant validity was indicated by negligible correlations with openness, extraversion, and agreeableness (all r ≤ .08), small negative correlations with conscientiousness (r = - .11 to - 0.13), and small to moderate positive correlations with neuroticism (r = .16 - .33). Conclusions: Premenstrual symptoms are highly prevalent and associated with substantial psychological and functional burden in adolescents. The PMS-I-Y, an adolescent-adapted version of an existing instrument, shows promising psychometric properties for assessing premenstrual impairment in this age group. However, findings should be interpreted with caution due to the use of retrospective self-report measures, potential sampling bias resulting in a self-selected sample, and the lack of prospective diagnostic assessment. Accordingly, prevalence estimates reflect retrospective symptom reporting operationalized questionnaire criteria rather than clinical diagnoses.

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