Severe premenstrual tension: delineation of the syndrome.

Forty-two women with severe premenstrual tension syndrome (PMTS) were studied to define the clinical phenomenology and examine its resemblance to common psychiatric disorders. They were mature, adult women suffering severe emotional and physical symptoms in the premestruum but well at other times. Their mean premenstrual score on the Menstrual Distress Questionnaire (MDQ) was twice as high as in the study of Moos. Symptoms showed a marked On--Off phenomenon between premenstrual and follicular evaluations with all rating instruments (p less than 0.001). Existing scales for depression, anxiety, and hostility did not demonstrate that the core disturbance of PMTS is any of these dimensions alone. Item analysis of the MDQ revealed that irritability, mood lability, tension, and restlessness were the most prominent emotional descriptors of this specific syndrome. Several indicators of impaired intellectual and physical functioning were also noted. In most of these women PMTS occurred in the absence of other psychopathology. Subclinical characterological and neurotic disturbances when present were probably exacerbated in the premenstrual period. PMTS is not a clinical model for recurrent affective disorders.