New Scoring System May Improve Reliability of PMDD Diagnosis

Premenstrual dysphoric disorder (PMDD)—which was added to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)—is a debilitating condition characterized by the emergence of mood and emotional symptoms in the luteal phase of the menstrual cycle.

This condition is difficult to diagnose, however, because doing so prospectively requires the evaluation of daily symptom ratings and their fluctuations over a two-month period. As such, many clinicians make decisions through a retrospective analysis of a patient’s symptoms, which is known to be prone to false positives, according to the authors.

A study published in AJP in Advance has proposed a new approach termed the Carolina Premenstrual Assessment Scoring System (C-PASS). Through this computerized procedure, clinicians can enter patient-provided ratings on a spreadsheet that determines a PMDD diagnosis based on a standardized thresholds. 

The study authors compared the C-PASS diagnoses of 200 women who had submitted their symptom ratings each week with those of an expert clinician who also reviewed prospectively and found a 94.5% agreement between the two (11 disagreements).

“The current C-PASS materials may be immediately useful clinically,” the study authors concluded. “However, additional development is needed to digitize data collection and streamline the diagnostic process for clinical application.”

(istock/KatarzynaBialasiewicz)