Evaluation of psychiatric symptoms in patients presenting with symptoms of premenstrual tension syndrome.

The principal psychiatric syndrome seen in patients with premenstrual tension syndrome is depressive disorder. Questions that should be used to evaluate depression are reviewed and the addition of structured questionnaires for the depressive symptoms is not considered useful in this assessment. Other conditions that may or may not be related to the premenstrual period include psychosis (especially depression and mania), alcoholism, anxiety, and bulimia. Brief questioning concerning these conditions can be performed relatively quickly during the clinical evaluation. Second-source information should be obtained when at all possible. If treatable psychiatric illness is identified in those with premenstrual tension, it should be treated as if the psychiatric syndrome alone were present. There is no indication, however, that such treatment will alter the course of the premenstrual condition should it be present as well.