Talk:Premenstrual dysphoric disorder

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[edit] Deletion of past talk page

Earlier, the PMDD article was subjected to repeated vandalism, in the form of unsupported claims to the effect that there was "controversy" about whether PMDD existed. The controversy was given as pretext for misogynistic innuendo smearing PMDD as merely a socially constructed malady hyped by manipulative women to excuse periodic bitchy outbursts.

Refutation of the non-existent controversy included a Swedish P.E.T. study showing objectively that mood changes correlate to changes in brain serotonin precursor trapping in women with premenstrual dysphoria. Since the past vandalism was persistent and recurring, this citation should not be lost.

The PubMed citation for the P.E.T. study is http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16515859&dopt=Abstract and the full article is as follows:

Psychiatry Res. 2006 Mar 31;146(2):107-16. Epub 2006 Mar 2

Mood changes correlate to changes in brain serotonin precursor trapping in women with premenstrual dysphoria.

     * Eriksson O,
     * Wall A,
     * Marteinsdottir I,
     * Agren H,
     * Hartvig P,
     * Blomqvist G,
     * Langstrom B,
     * Naessen T.

Department of Women's and Children's Health/Obstetrics and Gynecology, University Hospital, SE-751 85 Uppsala, Sweden. olle.eriksson@kbh.uu.se

The cardinal mood symptoms of premenstrual dysphoria can be effectively treated by serotonin-augmenting drugs. The aim of the study was to test the serotonin hypothesis of this disorder, i.e. of an association between premenstrual decline in brain serotonin function and concomitant worsening of self-rated cardinal mood symptoms. Positron emission tomography was used to assess changes in brain trapping of 11C-labeled 5-hydroxytryptophan, the immediate precursor of serotonin, in the follicular and premenstrual phases of the menstrual cycle in eight women with premenstrual dysphoria. Changes in mood and physical symptoms were assessed from daily visual analog scale ratings. Worsening of cardinal mood symptoms showed significant inverse associations with changes in brain serotonin precursor trapping; for the symptom "irritable", r(s)=-0.83, and for "depressed mood" r(s)=-0.81. Positive mood variables showed positive associations, whereas physical symptoms generally displayed weak or no associations. The data indicate strong inverse associations between worsening of cardinal symptoms of premenstrual dysphoria and brain serotonin precursor (11C-labeled 5-hydroxytryptophan) trapping. The results may in part support a role for serotonin in premenstrual dysphoria and may provide a clue to the effectiveness of serotonin-augmenting drugs in this disorder but should, due to small sample size and methodological shortcomings, be considered preliminary.

PMID: 16515859 [PubMed - indexed for MEDLINE]

[edit] Criticisms section

In the criticisms section it says something to the effect that severity of a disorder is not a medical attribute. As someone working in the allied health fields, I would disagree and say that severity is an extremely important concept in medicine, psychiatry in particular, and that this part of the section may violate NPOV. Ehb 18:45, 9 February 2007 (UTC)

Severity is a subjective, not objective, trait. Someone who says something really hurts may really just have a low pain tolerance. I work in the medical field as well and sometimes people, to be frank, can be rather exagerating and intolerant of any sort of suffering. Pmdd can be nothing more than a women's inability to cope with the same symptoms that someone who can cope with it has. PMDD seems to me just another medical scapegoat, to say "oh its not my fault I am different I have PMDD and I need to buy drugs." I think its a crime to use medical study in this way.
First off, mental illness is generally defined by a condition being so debilitating it affects the individual's ability to function normally in society; the fact that someone else might be unaffected in a similar situation is irrelevant. Second off, it still seems inappropriate to have these criticisms in the article at all unless one can point to a notable effort by a public figure or publicly known organization to advance the view you describe. I think the criticisms should be removed unless they are better documented and referenced. --Soultaco 00:34, 6 May 2007 (UTC)

Should the entire Criticism section be deleted?! Wikipedia should only present acknowledged facts, not original opinions of minor groups. Heidit

Why does it seem this article is written by a drug company?

Not a drug company, it seems to be written by a pissed off feminist who doesn't want her inner workings being displayed on Wikipedia.

Comment Whether a clinical condition or not, living with a partner who has PMDD or severe PMS is a nightmare. It's a nightmare also for the women concerned where the only solution is medication to numb evry bit of feeling and emotion inside. The common notion of either Doctors just wanting to pigeon-hole (& medicate) a difficult patient or the patient herself being hypochondrical or exaggerating doesn't cover everyone. My opnion is if you haven't any experience living with it or as a practicisng clinician caring for patients then stay out of the disussion. You don't know! --Jppigott 01:44, 20 March 2007 (UTC)

I can understand what you are saying, but I think there is still room for criticism as it may not cover "everyone" but it can still cover some. So the argument is whether the result of pmdd is for the most part exaggeration by some women or that enough of them genuinely suffer from it to consider it a separate medical condition meriting its own name. If severity is a trait of something (such as pms) then could we not just refer to it as severe pms with severity being a trait of that condition. And in regards to experiencing it, you are right. A lot of doctors are men, and some of them do not have any experience with even minor ill-effects of the menstrual cycle which can be a reason to say that severity of pms is going unnoticed and should be taken more seriously and yes, even merit considering it its own situation. But we are only human : )The point I am trying to make is that there is room for a criticism section, and that I think it would be best to leave something rather than delete the entire thing. I did notice no citation though, and think that because this is an encyclopedia and not a discussion forum that it should be supported by genuine evidence on the critique.

[edit] I think

The Veronicas have been promoting the awareness of this?

It is sad to think that with such medical advances that the subject of Pmdd is so controversial. If this was a disease of all people the treatment would be sought and that would be the end of discussion. Just like depression, something the coincides with pmdd for years has been marked as "all in someone's head". Granted there should not be a pat answer of pushing medication, but in the same token there should be an answer not just a criticism. —Preceding unsigned comment added by 72.19.34.193 (talk) 03:42, 7 September 2007 (UTC)

[edit] How do you get a treatment ... without applying a psychiatric label?

Menses and perimenopause are part of a healthy life, yet cause some women unpleasant or disabling symptoms. Under the U.S. medical model it seems there is no treatment without a diagnosis of pathology. The model isn't well-adapted to the situation where a treatment can reduce the hardship some women experience in normal or perimenopausal menstrual cycles.

Treatment with SSRIs is effective, but does have side effects, which ideally would be weighed by a woman against her symptoms, perhaps aided by her doctor, to allow her to decide based on her own balance. Since menses and perimenopause are both normal, she shouldn't have to first be declared to suffer from a psychiatric disorder. Normal menses makes many demands on the body, but that hardly makes it a pathology -- like menses-related iron-depletion anemia, the sufferer and the symptoms deserve respect -- and the sufferer deserves to have the symptoms treated without being labeled as diseased. Anyone who can think of suggestions about how to get relief from PMDD for those women who need it, without applying a psychiatric label, please add them below. Please feel free to think outside the box. 67.101.68.116 14:01, 16 September 2007 (UTC)ocdcntx

Make one or more SSRIs available over the counter? 67.101.68.116 14:01, 16 September 2007 (UTC)ocdcntx