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After completing this case study, the reader should be able to:

  • Differentiate between the clinical presentation and diagnosis of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

  • Identify the desired therapeutic outcomes for patients with PMDD.

  • Design an appropriate therapeutic plan for a patient with PMDD.

  • Design an appropriate monitoring plan for a patient with PMDD, taking into account patient-specific factors (Table 94-1).

  • Educate patients and other healthcare professionals about PMDD and therapeutic options.

TABLE 94-1Item Content of the Daily Record of Severity of Problems (DRSP)3


Chief Complaint

“I think my boss may fire me if I don’t get some help.”


Gloria Gray, a 29-year-old woman, is an established patient at the Family Physician clinic who returns with complaints of bloating, breast tenderness, angry outbursts, irritability, depression, and fatigue. She has kept a record of her symptoms over the past 3 months, and it appears that her symptoms occur during the last week of her menstrual cycle each month. During this time, she really has a difficult time at work in particular. She gets angry easily and yells at coworkers. She feels very fatigued during this time, which causes her to lose focus and fall behind on her work. She is ...

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