Premenstrual dysphoric disorder—an undervalued diagnosis? A cross-sectional study in Hungarian women

Premenstrual dysphoric disorder (PMDD) is a common but underdiagnosed mental health problem among women of reproductive age, which complicates women's daily lives with the presence of severe psychological symptoms altering everyday functioning. This study aimed to assess the prevalence of probable PMDD, the anxio-depressive symptom severity, and well-being in women affected by PMDD across the menstrual cycle. 112 women with regular menstrual periods, without hormonal contraceptives were included. The study assessed the presence of probable PMDD using a DSM-5-based screening tool, a retrospective questionnaire assessment, for the detection of premenstrual symptoms. Anxio-depressive symptoms and well-being were assessed using the Beck Depression Inventory, the state subscale of the State-Trait Anxiety Inventory, and the WHO Well-Being Scale. Based on a DSM-5-based screening Tool, the sample was divided into women with probable PMDD diagnosis (PMDD group, n = 68) and women without probable PMDD diagnosis (nonPMDD group, n = 45). The PMDD group reported significantly more severe depressive (F(1; 56.2) = 19.394, p ≤ 0.001) and anxiety (F(1; 35.6) = 17.714, p ≤ 0.001) symptoms and lower well-being (F(1; 44.3) = 4.288, p = 0.04) compared to the non-PMDD group. A binomial logistic regression model was used to examine which factors predict PMDD: the model was significant (χ2(2) = 27.287, p ≤ 0.001), it explained 29.2 % of the variance in PMDD, and classified 71.4 % of the cases correctly. Anxiety (B = 0.058, S.E. = 0.022, Waldχ2(1) = 7.142, p = 0.01, OR = 1.060) and depressive (B = 0.085, S.E. = 0.031, Waldχ2(1) = 7.480, p = 0.01, OR = 1.089) symptoms predicted the likelihood of probable PMDD. Women even with probable PMDD experience significant affective difficulties and lower well-being, which underscore the need for attention towards psychological symptoms even in the case of probable PMDD, and consequently highlights the importance of appropriate assessment and treatment of the clinical appearance of PMDD.