The Psychiatrist : Clinical and Therapeutic Journal
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The suggested diagnostic category in DSM-III-R is Late Luteal Phase Dysphoric Disorder (LLPDD), a severe type of premenstrual disorder. Core symptoms without psychotic characteristics include mood instability and dysphoria. Nevertheless, the literature has long described momentary psychotic symptoms that occur during the late luteal phase and menstruation. Patients with these disturbing impacts may dynamically fall under the suggestive classifications of "abnormal psychosis," "occasional psychosis," and "cycloid psychosis," even if there is a great deal of incomplete information available about them. This article features a few patients who exhibit premenstrual psychoses. The studies on psychoses during menstruation and the LLPDD diagnostic standards are reviewed below.

A woman's menstrual cycle lasts nearly 30–35 years. It is a cyclic physiological process that takes place every month and can progress as an individual's psychological state changes. These changes were described by a number of authors, from Hipocrates in 600 B.C. to Troutula of Salamis in the 11th century and by a number of outsiders during the Renaissance. A few occasional psychological and physical symptoms that only appear one week before menstruation are significant. Some of these signs include exhaustion, insomnia, breast tenderness and swelling, hand and foot perspiration, weight gain, headache, nausea, or diarrhoea, and eating problems. These negative effects are certain to occur in about 3/4 of the female population [1]. Some women may experience these symptoms to such an extent that it interferes with their ability to work, maintain social and familial ties, or perform well in school. Honest first described this clinical condition as Premenstrual Pressure Condition in 1931. In 1994, the Analytic and Measurable Manual of Mental Issues (DSM-IV-TR) changed its nomenclature to "Premenstrual Dysphoric Problem (PMDD)" and grouped it with other difficult-to-diagnose conditions.

Issue with premenstrual dysphoria

Premenstrual dysphoric disorder (PMDD) models are a clinical grouping for women who have significant useful weakening brought on by moderately severe premenstrual side effects. The DSM-III-R2 LLPDD criteria are somewhat modified by the PMDD criteria, and women who satisfy them are categorised on axis I as having a depressive disorder that is not further characterised. The ability to conduct epidemiologic, etiologic, and therapeutic studies in clearly defined groups of women has been made possible by advancements in the careful screening and analysis of women with PMS. Prospective symptom recording, scoring techniques, and thorough clinical psychiatric and medical evaluation are required to rule out coexisting mental and medical illnesses. Several promising pharmacologic treatment options have been suggested in studies on women with PMDD. For the finding of PMDD, something like five of 11 side effects referenced in DSM-IV-TR ought to be available; Symptoms should have been present for at least two months and dysfunction should be present. In this kind of presentation, the most common symptoms are rage, irritability, and aggressive behavior [2].

We all experience rage at some point in our life, but depending on the culture, experiences can vary. Spielberger and colleagues defined anger as a spectrum of emotions that span from a tense, angry condition to an extreme feeling characterised as "rage" in Spielberger and others (1991). It is a phenomenological internal emotional state that is linked to certain cognitive and perceptual distortions, according to Kassinove and Sukhodolsky (1995), because rage can be brief and mildly destructive. It may also be destructive, persistent, and of tremendous severity. Outrage is viewed as a gloomy emotion in many countries since it is thought that this emotion can be damaging when expressed openly and directly. It is hypothesised that the person may become more vulnerable to verbal and physical abuse as a result of the rage they display, in addition to suffering a severe reduction in self-esteem [3,4]. Conflicts in the home and other interpersonal interactions could also develop. It is also suggested that suppressing outrage is linked to a number of real issues, including hypertension, coronary artery infection, and malignant growth.

According to investigations, some characteristics of anger show differences between genders. Averill (1983) announced that ladies felt outrage as often as possible and seriously as men do and with comparable reasons . Compared to women, men are better able to express their anger. Women typically express their rage in a more indirect manner. Anger, a feeling that frequently leads to uncontrollable behaviour and has a detrimental impact on human existence in many ways, may accompany the symptoms of premenstrual syndrome. In this approach, PMDD may be more detrimental to women because it combines anger with premenstrual symptoms. Despite the possibility that hormonal changes are to blame for the high levels of rage felt during the premenstrual period, given the fact that it is forbidden for women to express their rage, it may also be thought of as the result of social worthiness developing during this period in contrast to other times. The majority of women in the Women's Anger Study conducted by Smith and Thomas (1996) rated themselves as "nervous" and "intolerant" prior to their menstrual period [5]. A decent lady doesn't show agression, rage, aggression, outrage, brutality and anxiety" . It's possible that during their premenstrual period, women who, as is typical, suppress their anger are losing control.

Conclusion

The goal of the current review was to determine the existence and intensity of indignation in women who met PMDD criteria and to investigate the relationship between these degrees of outrage and PMDD as well as other characteristics. Participants in the review included women with PMDD who were frequently sent to the Psychiatry Short Term Centre of the Psychiatry Division and healthy women as a control group. In the PMDD group, no gynaecological procedures were performed on participants who did not use oral contraception and were between the ages of 18 and 40.

Acknowledgment

None

Conflict of Interest

None

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