Does debilitating form of PMS exist?

Sarah Gehlert, Assistant Professor in the School of Social Service Administration, has received $1.5 million from the National Institutes of Health to determine whether Premenstrual Dysphoric Disorder actually exists.

Based on a pilot study two years ago, Gehlert estimates that more than 3.5 million women may suffer from PMDD, a debilitating form of premenstrual mood disorder. The disorder is so severe that the lives of one quarter of these women are in serious disarray, the study suggests. In addition, nearly all of these women will suffer from a period of major depression in their lives.

The American Psychiatric Association classified PMDD, the most extreme form of PMS, as a mental disorder and estimated prevalence rates between 3 and 5 percent of all reproductive-age women in the United States. Gehlert's study, the first systematic quantitative study of PMDD, found that from 4 to 7 percent of women suffer from the disorder.

The preliminary study of 200 women will now be replicated in a larger study. Gehlert and other researchers will conduct a study of more than 2,500 randomly selected women in Illinois and Missouri.

"It's surprising how little is known about premenstrual disorders -- even such fundamental questions as how prevalent these disorders are in the general population still remain unanswered," Gehlert said. "Expanding our research should aid in determining actual causes and treatments for premenstrual disorders as well as determine the accuracy of the PMDD definition based on the APA's criteria."

PMDD is currently diagnosed when a woman's premenstrual symptoms are so severe that debilitating mood and behavioral changes impair basic daily activities and relationships, resulting in a form of severe mood disorder.

The difficulty with the current diagnosis is that it is not officially recognized in psychiatric literature, which means it is difficult for clinicians to make an accurate diagnosis and difficult for women to get insurance coverage for treatment.

"It's a diagnosis completely gone amok," Gehlert said. "It's information pulled together by clinicians, not yet supported by empirical work."

It is also a controversial diagnosis -- many people are concerned that if it is formally recognized, PMDD will pathologize normal functioning, Gehlert said. Many women do not want the disorder to be considered a mental or emotional problem.

The researchers, including a group from Rush-Presbyterian St. Luke's Hospital, hope that continuing to examine PMDD will help refine the concept, provide a more clinical description and establish more accurate profiles of women with PMDD. Women for the study will be selected from urban and rural areas, from the entire range of the socioeconomic spectrum, from all races and ages.