MONDAY, March 5 (HealthDay News) -- For years, women with the severe form of premenstrual syndrome known as premenstrual dysphoric disorder (PMDD) were told that their symptoms should subside the day menstruation begins.
Now, new research suggests that these symptoms, which can include serious mood swings, start about four days before menstruation and can linger through the first three days of menses -- as many women with the disorder can attest.
This expanded PMDD definition will help researchers update the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), due out in May 2013. The DSM classifies mental disorders by precise definitions and diagnostic criteria, and it influences treatment decisions and insurance reimbursement.
"It was thought that PMDD symptoms would drop off sharply at the onset of menses, and now we realize they don't," said study author Dr. S. Ann Hartlage, director of the Marital and Sex Therapy Program at Rush University Medical Center, in Chicago.
Hartlage and colleagues surveyed more than 1,000 women with and without PMDD about their symptoms for one or two menstrual cycles.
PMDD differs from premenstrual syndrome (PMS) in the number of symptoms it includes and their severity. Both conditions may be marked by bloating, short-term weight gain, breast tenderness and certain mood changes. However, extreme mood changes, anxiety, depression, anger and irritability may occur with PMDD to such an extent that they interfere with functioning at work or at home.
Experts said the new findings, published in the March issue of the Archives of General Psychiatry, will affect how women with PMDD will be labeled.
"This revision of how PMDD is defined will have an impact on research studies down the line," said Dr. Christopher Estes, an assistant professor of obstetrics and gynecology at the University of Miami Miller School
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