A 33-year-old woman has recurrent premenstrual irritability, depressed mood, breast tenderness, and bloating that begin 5–7 days before menses and fully resolve within 2–3 days of onset. Symptoms are severe enough to disrupt work relationships and require prospective charting over 2 cycles. The DSM-5 diagnosis is:
- A Premenstrual syndrome (PMS)
- B Late luteal phase dysphoric disorder
- C Premenstrual dysphoric disorder (PMDD) ✓
- D Cyclothymic disorder
Explanation
Premenstrual dysphoric disorder (PMDD) is a DSM-5 depressive disorder requiring at least 5 symptoms (including at least one affective symptom: mood lability, irritability, depressed mood, anxiety) in the late luteal phase, confirmed by prospective daily ratings over at least two cycles, with full remission post-menses. It must cause marked functional impairment. PMS is milder, does not require the symptom threshold or prospective documentation, and generally lacks the degree of impairment. First-line treatment is SSRIs (which can be used continuously or luteal-phase only) or drospirenone-containing OCP.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.