Clinical utility of the premenstrual assessment form as an instrument auxiliary to the diagnosis of premenstrual dysphoric disorder

The Premenstrual Assessment Form (PAF) is a retrospective self-report questionnaire, yielding classification into syndromal categories and severity assessment (unipolar summary scales) of behavioral, psychological and physical premenstrual changes. However, the PAF has been criticized due to an overlap of its syndromal categories and the unipolar summary scores from symptomatic and asymptomatic women. PAF data from women seeking treatment for premenstrual symptoms and meeting a provisional diagnosis of premenstrual dysphoric disorder (PMDD; n = 30) were compared to a control group (n = 16). Results showed that 97% of the symptomatic group met the PAF depressive premenstrual syndrome criteria vs, only 12% of the control subjects (chi(2) = 29.9, P < 0.001). The symptomatic group also reported more severe premenstrual symptoms in all unipolar scales than the control subjects. Sixteen symptomatic women completed two menstrual cycles of prospective daily ratings, and half of them had their provisional diagnosis of PMDD confirmed. There were no significant differences in the scores of the PAF unipolar summary scales between the subgroups with or without the diagnosis confirmation. Most of the PAF scales displayed high sensitivity, but low specificity. These findings suggest that the PAF can be useful to differentiate clinical population and control samples, but it does not provide information to make a more definite diagnosis of PMDD. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.