Dysphoric Disorder, or also known as Premenstrual Dysphoric Disorder in the most current nomenclature, is the combination of psycho-affective symptoms that occur systematically in the luteal phase of the menstrual cycle. That is, between the ovulation and menstruation. It can involve, although not always, physical symptoms, like the ones mentioned in other articles, but due to the importance of the psychic symptomatology that can severely affect women who suffer from it, it has been subjected to many psychiatric studies.

In the light of the discovery by Dr. Lolas Talhami, Dysphoric Disorder is not different from Premenstrual Syndrome. It is simply a symptomatic affection from the psycho-affective field with the same cause and treatment as organic symptoms. If you feel you meet the diagnostic criteria for Premenstrual Dysphoric Disorder, consider measuring severity of your disorder and compare it with other patients’, and eventually, get a quote for treatment.

Premenstrual symptoms are sorted by type in the former International Disease Classification (ICD-9), code 625.4, and in the new catalog (ICD-10) that will come into effect October 1, under code N94.3. The American Psychiatric Association manual specifies the diagnostic criteria for Dysphoric Disorder (Diagnostic and Statistical Manual of Mental Disorders 5th ed.).

DSM-5 Criteria

A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post-menses.

B. One (or more) of the following symptoms must be present:

  1. Marked affective lability (e.g., mood swings: feeling suddenly sad or tearful, or increased sensitivity to rejection)
  2. Marked irritability or anger or increased interpersonal conflicts
  3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts
  4. Marked anxiety, tension, and/or feelings of being keyed up or on edge

C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.

  1. Decreased interest in usual activities (e.g., work, school, friends, hobbies)
  2. Subjective difficulty in concentration
  3. Lethargy, easy fatigability, or marked lack of energy
  4. Marked change in appetite; overeating; or specific food cravings
  5. Hypersomnia or insomnia
  6. A sense of being overwhelmed or out of control
  7. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain
  • Note: The symptoms in Criteria A-C must have been met for most menstrual cycles that occurred in the preceding year.

D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).

E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders).

F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation).

G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism).