Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women: The Harvard Study of Moods and Cycles

Cohen, Lee S; Soares, Claudio N; Otto, Michael W; Sweeney, Bernadette H; Liberman, Rebecca F; Harlow, Bernard L

« Previous Next »Journal of Affective Disorders
Volume 70, Issue 2 , Pages 125-132, July 2002

Prevalence and predictors of premenstrual dysphoric disorder (PMDD) in older premenopausal women:

The Harvard Study of Moods and Cycles

Lee S Cohen
- Harvard Medical School, Boston, MA, USA
- Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital—Harvard Medical School, 15 Parkman Street WACC 815, Boston, MA 02114, USA
- Corresponding author. Tel.: +1-617-724-8020; fax: +1-617-726-7541
Claudio N Soares
- Harvard Medical School, Boston, MA, USA
- Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital—Harvard Medical School, 15 Parkman Street WACC 815, Boston, MA 02114, USA
Michael W Otto
- Harvard Medical School, Boston, MA, USA
Bernadette H Sweeney
- Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital—Harvard Medical School, 15 Parkman Street WACC 815, Boston, MA 02114, USA
Rebecca F Liberman
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Boston, MA, USA
Bernard L Harlow
- Harvard Medical School, Boston, MA, USA
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital, Boston, MA, USA

Received 4 June 2001; received in revised form 25 September 2001; accepted 3 November 2001.

Abstract

Background: Consistent data on the prevalence and predictors of premenstrual dysphoric disorder (PMDD) in the general population are lacking. Methods: Premenstrual symptoms of 4164 women (aged 36–44 years) were retrospectively assessed by the Moos Premenstrual Inventory. From this original sample, 976 subjects were further interviewed at which time demographic and lifestyle characteristics, gynecologic history, and medical conditions were examined. The Structured Clinical Interview for DSM-IV Axis I disorders (SCID) was used to assess past and current psychiatric morbidity. Additionally, 513 of these women completed a prospective evaluation of premenstrual symptoms by using the Daily Rating of Severity of Problems Form (DRSP). Results: The diagnosis of PMDD was confirmed in 33 of 513 women (6.4%) who completed the prospective evaluation with daily records. Fourteen subjects (2.7%) met criteria for PMDD without a previous history of depression. PMDD was associated with lower education (odds ratio [OR]=2.3, confidence interval [CI]=1.1–4.9), a history of major depression (OR=3.6, CI=1.7–7.4), and current cigarette smoking (OR=4.1, CI=1.5–11.1). In addition, women not working outside the home were significantly less likely to meet criteria for PMDD (OR=0.2, CI=0.1–0.9). Limitations: Only 513 of 976 women agreed to have their symptoms documented prospectively. Symptoms were assessed over the course of one menstrual cycle. Conclusions: This study indicates a significant prevalence of PMDD in a large community-based sample. Given the associated impairment in social and occupational functioning seen in PMDD, these prevalence data provide a strong rationale for enhanced recognition and treatment of the disorder.

Keywords: PMS, Prevalence, Predictors, Premenstrual dysphoric disorder, PMDD