Premenstrual dysphoric disorder: controversies surrounding the diagnosis

There is little difference between LLPDD and PMDD. The names are different, and the criteria for PMDD include one more symptom (a subjective sense of being overwhelmed or out of control) than do those for LLPDD. Both diagnoses pertain to women with premenstrual complaints who suffer primarily from affective symptoms severe enough to interfere seriously with their lives. Recent controversies surrounding PMDD concern what meaning should be attributed to the clinical and research information that is now available on the condition. Some believe that there is abundant evidence to indicate that PMDD is a mood disorder; others argue that the meaning of the data is unclear. (See Gold and Severino for a comprehensive summary of the issues surrounding this diagnosis.) The nosological shift to categorize PMDD as a depression not otherwise specified implies that "enough information is available to indicate the class of disorder that is present." The validity of this assumption is questioned by some. Coding PMDD as a depression will encourage clinicians to view women with PMDD as depressed, will encourage women with the condition to view themselves as depressed, and will influence researchers' conceptualization of study designs in very complex and subtle ways that may go unquestioned.