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Using the Daily Record of Severity of Problems as a Screening Instrument for Premenstrual Syndrome

From the ¹Departments of Medicine and Health Services Research, Cedars-Sinai Health System and the UCLA School of Medicine, Los Angeles, California; ²Cerner Health Insights, Beverly Hills, California;³Departments of Psychiatry, Epidemiology, and Public Health, Yale University School of Medicine, New Haven, Connecticut; and ⁴New York State Psychiatric Institute and the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.

OBJECTIVE: To assess symptom ratings on the first day of menses to identify women at high risk of clinically significant premenstrual syndrome (PMS) who should undergo further evaluation.

METHODS: A cohort of 697 women kept daily symptom ratings using the Daily Record of Severity of Problems (DRSP). The DRSP includes 21 symptom items grouped within 11 domains. DRSP scores on the first day of menses were calculated using the sum of all 21 items (standard method), the sum of the highest rated items within each domain (alternative method), and the sum of seven items derived from modeling. Seventy percent of the study sample was randomly assigned into a model-building set to identify optimal cutoff scores for PMS screening. The remaining 30% comprised a testing set used to compare PMS screening results to a PMS diagnosis based on two cycles of daily DRSP ratings.

RESULTS: Of the initial study sample, 388 participants (55.7%) completed two cycles of daily ratings. The prevalence of PMS was 30.4%. In the model-building set, the positive and negative predictive values of the 21-item DRSP scores were 53.8% and 83.4% using the standard method and 52.7% and 84.0% using the alternative method. Corresponding values were 55.0% and 84.9% for an abbreviated seven-item DRSP version. These results were confirmed in the testing set.

CONCLUSION: The DRSP administered on the first day of menses is an acceptable screening instrument to identify women who may have PMS.

LEVEL OF EVIDENCE: II