Psychiatric screening in the premenstrual syndrome

Prospective daily ratings of premenstrual symptomatology were obtained from 40 women for one full menstrual cycle. Nineteen of these women were complaining of suffering from a premenstrual syndrome. The General Health Questionnaire (GHQ) was administered in the mid-follicular and late luteal phases of the cycle. Women who were complaining of the premenstrual syndrome showed significant premenstrual increases in premenstrual symptoms, of a magnitude that was significantly greater than those of control subjects. The GHQ scores of the women who were complaining of premenstrual syndrome were significantly higher than those of the control subjects in both the follicular and luteal phases of the cycle. The mean GHQ score of the group with premenstrual syndrome was significantly elevated above the published normal value. Fifty-six per cent of those who complained of premenstrual syndrome had follicular GHQ scores which were higher than the recommended threshold for clinical psychiatric disturbance. Only 10.5% of the control group were above this threshold. General Health Questionnaire scores were stable across phases of the cycle and were correlated to the severity of symptoms of premenstrual syndrome. Premenstrual Moos Menstrual Distress Questionnaire (MDQ) scores were related strongly to follicular MDQ scores. A high proportion of women who complain of premenstrual syndrome show evidence of a more general psychiatric problem which should be evaluated before therapy.