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Interview study, 2022

Are doctors correctly diagnosing PMDD or mistaking it for depression or anxiety?

All four women interviewed were initially misdiagnosed with depression or anxiety rather than PMDD. The key to accurate diagnosis was recognizing that symptoms followed the menstrual cycle.

Early or limited evidence Women with PMDD in the United Kingdom, aged 30 to 50 years

What they did

Researchers interviewed women with PMDD across the United Kingdom about their diagnosis experiences and the impact of being misdiagnosed. They also tested three diagnostic questionnaires to see how well each one identified PMDD.

What they found

All four women interviewed had been misdiagnosed with major depression and/or generalized anxiety disorder. They all received a correct PMDD diagnosis only when they or their doctors recognized the cyclical pattern of symptoms. The Premenstrual Symptom Screening Tool identified the most symptoms and performed better than the other two questionnaires tested.

What it means for you

PMDD is frequently misdiagnosed as depression or anxiety, leading to wrong treatments. Women and doctors need to know that symptoms following the menstrual cycle is the key to recognizing PMDD. The study is very small with only four detailed interviews, so these findings need confirmation in larger studies.

4

women interviewed in detail

About the study

Original title
Pardon My Sobbing: A Qualitative Study on Differentiating Generalised Mood Disorders From Premenstrual Dysphoric Disorder
Authors
Pradhan A
Journal
BJPsych open
Year
2022
Study design
Interview study
Participants
50
Open access
Yes
Original abstract

Aims: To assess current diagnostic methods used in the United Kingdom which have led to successful diagnoses of PMDD (Premenstrual Dysphoric Disorder). Methods: Women suffering from PMDD were recruited across the United Kingdom. Participants were interviewed using a semi-structured interview guide about their paths to diagnoses and the impact of receiving a misdiagnosis. Interviews were transcribed and thematically analysed to assess for overarching themes and similarities across participants. The Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 survey, and Premenstrual Symptom Screening Tool were used to assess for each questionnaire's diagnostic ability. Results: Four women aged 30–50 years all identifying as PMDD patients were interviewed. All four participants received misdiagnoses of major depressive disorder and/or generalised anxiety disorder. The key to achieving a PMDD diagnosis for all four women was awareness of the cyclical nature of their symptoms. All three surveys failed to fulfill all the diagnostic criteria for PMDD, however the Premenstrual Symptom Screening Tool performed the best and elicited the greatest number of symptoms from the population sample. Conclusion: This research showed the need for patient awareness of PMDD via research, or awareness of the relationship between symptoms and the menstrual cycle, to achieving a diagnosis and receiving adequate treatment. Specialist treatment was also imperative to achieving a formal diagnosis.

Reproduced under CC-BY.

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