Department of Psychiatry, Rush University Medical Center, 2150 W Harrison St, Chicago, IL 60612
J Clin Psychiatry. 2014 Jan;75(1):70-6. doi: 10.4088/JCP.13cs08368.
Inclusion of premenstrual dysphoric disorder (PMDD) into the main text of the DSM has been a point of controversy for many years. The purpose of this article is to address the main concerns raised by opponents to its inclusion. Concerns are presented and countered in turn.
To identify the most prevalent arguments against inclusion of PMDD, we searched MEDLINE (1966-2012), PsycINFO (1930-2012), the Internet, and reference lists of identified articles during September 1-17, 2012, using the keywords PMDD, premenstrual syndrome (PMS), DSM, DSM-5, concerns, controversy, women, political power, workforce, courts, and history. The search was restricted to English-language publications. A total of 55 articles were identified and included. The most pressing arguments against inclusion were grouped by similarity and addressed if they were reported 5 or more times. Our review of the sources yielded 38 concerns regarding PMDD; 6 concerns were reported at least 5 times and are addressed in this article.
Evidence culled from historical and legal trends does not support the alleged societal use of PMS to harm women (eg, keeping women out of the workforce or using PMS against women in child custody disputes). Further, current epidemiologic research has answered all of the methodology criticisms of opponents. Studies have confirmed the existence of PMDD worldwide. The involvement of pharmaceutical companies in research has been questioned. However, irrespective of the level of association with industry, current research on PMDD has consistent results: PMDD exists in a minority of women.
Historically, the pain and suffering of women have been dismissed, minimized, and negated. Similarly, women with PMDD have often had their experience invalidated. With the preponderance of evidence in its favor, PMDD has been placed in the main text of the DSM-5, opening the door for affected women to receive the attention full diagnostic status provides.
将经前期烦躁障碍（PMDD）纳入 DSM 正文多年来一直是备受争议的问题。本文旨在探讨反对将其纳入的主要关注点。我们依次呈现并反驳这些关注点。
为了确定反对纳入 PMDD 的最普遍观点，我们于 2012 年 9 月 1 日至 17 日，使用 PMDD、经前期综合征（PMS）、DSM、DSM-5、关注、争议、女性、政治权力、劳动力、法院和历史等关键词，在 MEDLINE（1966-2012 年）、PsycINFO（1930-2012 年）、互联网和已确定文章的参考文献中进行检索，共检索到 55 篇文章，并纳入分析。对最紧迫的反对纳入的观点进行相似性分组，并在有 5 次以上报道时进行讨论。对资料来源的综述得出 38 项与 PMDD 相关的关注点；其中有 6 项关注点至少报道了 5 次，并在本文中进行了讨论。
从历史和法律趋势中获取的证据并不支持所谓的社会利用 PMS 来伤害女性（例如，使女性无法参与劳动力大军，或在子女监护权纠纷中利用 PMS 对付女性）。此外，当前的流行病学研究已经回应了反对者在方法学上的所有批评。研究已经证实了 PMDD 在全世界范围内的存在。制药公司参与研究的情况受到质疑。然而，无论与行业的关联程度如何，当前关于 PMDD 的研究都有一致的结果：PMDD 在少数女性中存在。
从历史上看，女性的痛苦和苦难被忽视、最小化和否定。同样，患有 PMDD 的女性的经历也经常被否定。鉴于大量证据支持 PMDD，它已被纳入 DSM-5 的正文，为受影响的女性打开了获得充分诊断地位所提供的关注的大门。
