Variance in Mood Symptoms Across Menstrual Cycles: Implications for Premenstrual Dysphoric Disorder

ABSTRACT

Premenstrual dysphoric disorder (PMDD) remains a controversial diagnosis: Some authors have argued that it pathologizes normal mood changes, and others have questioned the need for daily mood reports across multiple cycles. In the present study, we examined changes in mood among psychologically healthy young participants with regular menstrual cycles. We collected daily reports of negative mood (depression, nervousness, irritability, and fatigue) across two to six consecutive cycles from 27 participants aged 18–35 years, and we used variance decomposition analyses to examine how much of the variance in these daily reports was due to day, cycle, and individual. The majority of variance (79%–98%) was due to daily fluctuations and did not conform to a standard pattern of premenstrual rise/postmenstrual fall. These findings suggest that PMDD is not simply an exaggeration of mood patterns typical for psychologically healthy people. Individual patterns were relatively stable from cycle to cycle; thus tracking deviations from a patient's own normative mood patterns may have greater clinical utility than deviation from a presumptive norm.

KEYWORDS:

• mood
• premenstrual dysphoric disorder
• daily diary
• menstrual cycle
• variance decomposition

Acknowledgments

The authors thank Amy Harris, Rebecca Bedwell, Jennifer Burch, Emily Chester, and Kirstin Clephane for assistance with data collection and preparation for analysis.

Funding

Dr. Lorenz was supported by a grant from the NICHD (T32HD049336), and Dr. Vitzthum was supported by a grant from the NSF (1319663). Data collection was funded by the Kinsey Institute and Indiana University.

Notes

1 As the majority of this article is concerned with the process of menstruation, we use the terms people who menstruate or non-gendered individual in recognition of the fact that not all people who menstruate identify as women, and not all women menstruate. However, when describing arguments made on the basis of gender (e.g., the characterization of mood cyclicity as “typical of women”), or describing the results of studies that were targeted toward self-identified women, we use the terms woman or women as appropriate.

2 All recruitment materials specified “women”—thus we use the gendered term here.