PREMENSTRUAL DYSPHORIC DISORDER AND EATING DISORDERS

Premenstrual Dysphoric Disorder (PMDD) can be differentiated from Prem enstrual Syndrome (PMS) by the use of the research criteria provided b y the Diagnostic and Statistical Manual (DSM) IV. Indeed, PMS correspo nds to mild clinical symptoms, such as breast tenderness, bloating, he adache and concomitant minor mood changes, while premenstrual magnific ation occurs when physical and psychological symptoms of a concurrent axis I disorder get worse during the late luteal phase. Changes in app etite and eating behavior have been documented in women suffering from PMS, with an increased food intake occurring during the luteal phase. Moreover, in women with PMS, a major effect of the phase of the menst rual cycle on appetite has been documented and a high correlation with self-ratings of mood, particularly depression, has been described onl y in such disturbance. The aim of the present study was to analyse the clinical similarities between PMDD and Eating Disorders (in particula r Bulimia Nervosa and Binge Eating Disorder). Thus, we compared the DS M III-R comorbidity, the personality dimensions and the eating attitud es in these patients, attempting to identify any relationship between groups. Twelve PMDD women (mean age 28 years), diagnosed using DSM TV criteria and premenstrual assessor form, were compared with 10 eating disorder (ED) women (6 Bulimia Nervosa, 4 Binge Eating Disorder) (mean age 25 years) and with 10 control women matched for age. The followin g instruments were used: (i) clinical interview with DSM III-R criteri a (SCID); (ii) a psychometric study with TPQ for the evaluation of thr ee personality dimensions (novelty seeking, harm avoidance and reward dependence); (iii) EAT/26 for the evaluation of eating attitudes. Resu lts show that a high comorbidity for mood and anxiety disorders in PMD D and ED is well documented. Our PMDD patients share a 16.6% of comorb idity with ED, whereas such an association is present only in 2.3% of the general population. In addition, as a common clue, the personality dimension, harm avoidance, Linked to a serotonin mediation is signifi cantly more frequent in PMDD and ED than in normal controls. In conclu sion: from the present study it seems clear that a certain degree of s imilarity exists between the PMDD and ED. However, whether or not thes e two disorders really share common ground from a physiopathological p oint of view still has to be clarified by more extensive studies.