---
title: How should doctors determine which cycles count as PMDD? | Niyora
description: Different diagnostic methods give very different results. Using a 30% threshold for symptom presence and 50% for recovery after the period correctly identifie
url: https://niyora.com/research/papers/operationalizing-dsm-iv-criteria-for-pmdd-selecting-symptomatic-and-asymptomatic-2003/
---

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- How should doctors determine which cycles count as PMDD?

Cohort study, 2003

# How should doctors determine which cycles count as PMDD?

Different diagnostic methods give very different results. Using a 30% threshold for symptom presence and 50% for recovery after the period correctly identified 92% of PMDD cycles in women with PMS.

 Early or limited evidence

25 women with PMS and 25 controls, all with daily symptom tracking

## What they did

Methodological study analyzing how to apply PMDD diagnostic criteria. Researchers analyzed daily symptom ratings from two cycles each in 25 women with PMS and 25 controls, testing four different severity thresholds.

## What they found

Strict literal criteria (symptoms completely present or absent) identified only 28% of PMDD cycles. A 30% threshold correctly identified 86% of PMDD cycles and 70% of control women's cycles without symptoms. A 50% threshold identified 60% of PMDD cycles and 86% of control cycles. The best combination (30% for symptoms and interference, 50% for post-period symptoms) correctly identified 92% of symptomatic cycles in women with PMS and 72% of asymptomatic cycles in controls.

## What it means for you

Studies using different diagnostic methods will find different numbers of women with PMDD. Most women without PMS still have some symptoms before their period, making it hard to define who truly has PMDD. Researchers should always describe their method.

92%

Cycles correctly identified with optimal method

28%

Cycles correctly identified with strict criteria

72%

Asymptomatic cycles correctly identified

## About the study

Original title Operationalizing DSM-IV criteria for PMDD: selecting symptomatic and asymptomatic cycles for research Authors Smith MJ, Schmidt PJ, Rubinow DR Journal Journal of psychiatric research Year 2003 Study design Cohort study Participants 25 What was tested None - methodological study Read the paper [doi.org/10.1016/s0022-3956(02)00053-5](https://doi.org/10.1016/s0022-3956(02)00053-5)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)

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