Leslie Carol Botha: Helluva slippery slope for women with severe hormone imbalance. PMDD has been updated and classified as a ‘depressive disorder’. Another label that destroys women’s lives, is treated with drugs and a vicious cycle of judgement blame and prescriptions that don’t get to the root of the problem and that is balancing the hormones. If psychiatrist’s have their way more and more women will be diagnosed with PMDD.
PMDD: No News Is News for the APA
Society for Menstrual Cycle Research
Guest Post by Joan Chrisler, Connecticut College
July 11, 2012
I have to admit that I have not been closely following the news about the forthcoming edition (5th) of the Diagnostic and Statistical Manual of Mental Disorders, which is expected to be published by the American Psychiatric Association in May 2013. So, when our blog editor Elizabeth Kissling asked me to take a look at a recent update on PMDD in Psychiatric News, I was intrigued. As I read the article I found myself becoming irritable, very irritable, even angry – but, don’t worry about me; I couldn’t possibly have PMDD, as I no longer menstruate. No, my emotional liability has more to do with the psychiatrists’ tendency to play fast and loose with facts than it does with my physiology.
The “news” begins with a statement that PMDD has been “proposed” to be included in the section on depressive disorders rather than in the appendix, which is reserved for disorders that need more study and shouldn’t yet be used clinically. This is a canard. PMDD appears in both the appendix and the depressive disorders section of the current edition – the DSM-IV-TR, which was published in 2000. As a result, it is already being used clinically. Perhaps what they really mean to say is that it is being removed from the appendix because we already know enough about it. Hmmm.
Next, we are told that there has been an “explosion” of research on PMDD in the “past 20 years.” Why 20 years? PMDD was originally named Late Luteal Phase Dysphoric Disorder and proposed for listing in the DSM-II-R (1987); early research that was intended to support the new diagnosis was not convincing, which probably factored into the decision to change its name. The current edition of the DSM was published 12 years ago, and the original DSM-IV in 1995 (17 years ago). According to PsycINFO, the largest psychology database, there have only been 259 articles published since the most recent edition of the DSM appeared, which hardly seems like an explosion, especially if we consider that many of them are about PMS, not PMDD. Others are not empirical reports of studies about PMDD; they are literature reviews, critiques of the diagnosis, and articles about psychotherapy for women with the diagnosis. The 259 even include random studies of migraines, schizophrenia, bipolar disorder, and menopause. The psychiatrists believe that these studies provide “greater legitimacy” for the diagnosis. Sorry, but I am not convinced.