Premenstrual Syndrome: Ethical and Legal Implications in a Biomedical Perspective

As the work on a revised edition of the Diagnostic and StatisticaL ManuaL (OSM-llIR) progressed, a great controversy grew over the inclusion of a new diagnostic category, "Premenstrual Phase Dysphoric Disorder." Some nosologists and scientists who study premenstrual syndrome (PMS) felt that, while a specific psychiatric disorder does exist, it occurs relatively rarely. The disorder can be characterized by recurrent periods of dysphoria on a monthly basis, in synchrony with the menstrual period. "PMS" already exists as a diagnosis in leD 9, the international medical nomenclature. The category for DSM-IIIR was to be a specific psychiatric disorder concentrating on the dysphoric reaction, and not including all of the physical and mental symptoms that people have ascribed to this condition. Much of the controversy that ensued had little to do with the diagnostic category or the condition itself. Rather, it concerned feelings voiced by feminist groups that the new diagnostic category would be misleading, that it would inappropriately label women as mentally ill, and that it would be affixed not only to the dysphoric disorder, but everything else that happens psychiatrically to women.