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Survey study, 2003

What is the difference between PMS and PMDD, and how are they diagnosed?

PMS and PMDD are distinguished by how many symptoms are required. PMDD needs at least five symptoms, while PMS needs just one distressing symptom, and diagnosis requires daily diaries since no blood test exists.

Early or limited evidence Not applicable; this is a review of diagnostic criteria rather than a study of individual women

What they did

Review of diagnostic criteria comparing DSM-IV and ICD-10 definitions for PMS and PMDD, and discussing the role of daily symptom tracking in diagnosis.

What they found

DSM-IV requires at least five symptoms for PMDD while ICD-10 requires only one distressing symptom for PMS. Diagnosis requires timing symptoms in relation to menstruation, showing meaningful change in severity between phases, and confirmation with prospective daily diaries. No hormone or laboratory test indicates PMS.

What it means for you

There is no agreed global standard for diagnosing PMS. Different countries use different thresholds, so a woman might be diagnosed with PMDD in one place and just PMS in another. A blood test cannot diagnose these conditions, so daily tracking is essential. The key is that clinically significant PMS involves much worse symptoms before the period.

5

minimum symptoms required for PMDD in DSM-IV

1

minimum symptom required for PMS in ICD-10

About the study

Original title
Premenstrual syndrome and premenstrual dysphoric disorder: definitions and diagnosis
Authors
Freeman EW
Journal
Psychoneuroendocrinology
Year
2003
Study design
Survey study
What was tested
None; this is a review article

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