[Premenstrual dysphoric disorder. An overview of diagnosis, epidemiology and therapeutic approaches]

Even though premenstrual symptoms had been already described by Hippocrates, premenstrual dysphoric disorder (PMDD) was first mentioned as a special psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. In DSM-III-R-Appendix A is was called late luteal phase dysphoric disorder (LLPDD), Appendix A. Before this diagnosis was established based on operationalized criteria, the term premenstrual syndrome (PMS) was used for patients with severe premenstrual mood disturbances and physical symptoms. Many hypotheses about the pathophysiological mechanisms underlying PMS and PMDS led to different therapeutic strategies. While PMS was mainly treated by gynecologists, PMDD became of interest in psychiatric research. Several antidepressants, psychotherapy, sleep deprivation and light therapy have been investigated regarding their effectiveness in combatting premenstrual symptoms such as depression, tension, dysphoria and anxiety. Within the anti-depressants the best findings were for selective serotonin reuptake inhibitors (SSRIs).