SEASONALITY OF SYMPTOMS IN WOMEN WITH LATE LUTEAL-PHASE DYSPHORIC DISORDER

Objective: Both late luteal phase dysphoric disorder (LLPDD) and seaso nal affective disorder are cyclical disorders often manifested by ''at ypical'' depressive features. The goal of this study was to determine whether patients with LLPDD demonstrate substantial seasonal variation in symptoms. Method: Consecutive female patients attending a subspeci alty clinic in a university teaching hospital were assessed by means o f DSM-III-R criteria. All subjects completed the Seasonal Pattern Asse ssment Questionnaire, modified to include items on the seasonality of premenstrual symptoms. The results were compared with those of a group of female nonclinical subjects (N = 50). Results: One hundred patient s met the DSM-III-R criteria for LLPDD. Compared to the nonclinical gr oup, the LLPDD patients had a significantly higher mean global seasona lity score (an index of seasonality of mood and vegetative symptoms) a nd a significantly higher rate of seasonal affective disorder (38% ver sus 8%) as determined by Seasonal Pattern Assessment Questionnaire cri teria. Twenty-five percent of the LLPDD group rated their seasonal var iation in premenstrual symptoms as marked or sever, while 30% consider ed seasonal changes in overall symptoms to be a marked or severe probl em. Conclusions: These results suggest that patients with LLPDD have s ubstantial seasonal patterns in mood and premenstrual symptoms. These seasonal patterns have implications for the clinical assessment and tr eatment of LLPDD. For example, light therapy may be beneficial for wom en with seasonal worsening of LLPDD.