DSM-III-R →DSM-IV → DSM-V

The revised edition of the DSM-III-R introduced Late Luteal Phase Dysphoric Disorder (LLPDD) in the appendix as a condition “needing further study.” This was the first formal acknowledgment of severe premenstrual symptoms in the DSM, but LLPDD was not yet an official diagnosis.

The DSM-IV criteria for PMDD emphasized the timing, nature, and severity of symptoms, as well as the importance of distinguishing PMDD from other mood disorders. Specifically, the criteria required that:

→ Symptoms occur in the late luteal phase of most menstrual cycles during the past year and remit within a few days after the onset of menses.

→ At least five symptoms must be present, including at least one of the following: markedly depressed mood, marked anxiety, marked affective lability, or persistent and marked anger or irritability.

→ Other symptoms could include decreased interest in usual activities, difficulty concentrating, lethargy, changes in appetite, hypersomnia or insomnia, a sense of being overwhelmed, and physical symptoms such as breast tenderness or bloating.

→ The symptoms must cause significant interference with work, school, usual social activities, or relationships.

→ The disturbance is not merely an exacerbation of another disorder.

→ Prospective daily ratings must confirm these criteria during at least two symptomatic cycles.