Association Between Premenstrual Dysphoric Disorder and ADHD/ASD: A Review of Current Evidence

Diagnostic Criteria for PMDD
A- Timing of symptoms	Majority of menstrual cycles that occurred in the preceding year.	At least five symptoms must be present.
	The final week before the onset of menses.	At least five symptoms must be present.
	Within a few days after menses begins.	Symptoms must start to improve.
	The week following the end of menses.	Symptoms must become minimal or absent.
B- Core symptoms	At least one symptom must be present.
B- Core symptoms	Marked affective lability (e.g., mood swings, feeling suddenly sad or tearful, or increased sensitivity to rejection). Marked irritability or anger or increased interpersonal conflicts. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts. Marked anxiety, tension, and/or feelings of being keyed up or on edge.
C- Additional symptoms	At least one symptom must additionally be present, to reach a total of five symptoms when combined with Criterion B.
C- Additional symptoms	Decreased interest in usual activities (e.g., work, school, friends, hobbies). Subjective difficulty in concentration. Lethargy, easy fatigability, or marked lack of energy. Marked change in appetite, overeating or specific food cravings. Hypersomnia or insomnia. A sense of being overwhelmed or out of control. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.
D- Clinically significant functional impairment	Distress.
	Interference with work or school performance.
	Interference with usual social activities
	Interference with relationships with others.
E- Differential diagnosis and comorbidity	The symptoms must not simply be a worsening of an existing underlying disorder.	MDD Panic Disorder PDD* Personality Disorders
E- Differential diagnosis and comorbidity	PMDD may co-occur with any of these disorders.	MDD Panic Disorder PDD* Personality Disorders
F- Confirmation	Provisional Diagnosis	Confirmed Diagnosis
F- Confirmation	1. Based on retrospective reports (patient memory/history) or if prospective tracking has covered fewer than two cycles.	Prospective daily ratings of symptoms. Tracking must cover at least two symptomatic cycles.
G- Exclusion of physiological causes	Symptoms must not be the direct result of a substance or drug of abuse.
	Symptoms must not be side effects of a prescribed medication or therapy.
	Symptoms must not be caused by a general medical condition (e.g., hyperthyroidism).

* In ICD-11 dysthymic disorder.

PDD - Persistent depressive disorder; PMDD - Premenstrual dysphoric disorder; MDD - Major depressive disorder;

Table 2.

Study characteristics and instruments used for the assessment of ADHD, ASD, and PMDD.

Study	Type of the study	Recruitment Source	ADHD Assessment	ASD/Autistic Traits Assessment	PMDD Assessment	Additional Assessment Tools*
Dorani et al. [20]	cross-sectional observational	1. PsyQ outpatient clinic for Adult ADHD in The Hague, The Netherlands	1. Diagnostic Interview for ADHD in adults 2.0 based on DSM-IV criteria	-	1. Premenstrual dysphoria questions from the M.I.N.I. Plus	M.I.N.I. Plus-comorbidities EPDS GCS MCTQ
Broughton et al. [22]	cross-sectional observational	1. Online platform for research study participant recruitment (Prolific)	1. Endorsing the question: ‘Has a clinician ever diagnosed you with ADHD?’ 2. ASRS-v1.1	-	1. PSST	Endorsing the questions: ‘Has a clinician ever diagnosed you with depression?’ ‘Has a clinician ever diagnosed you with anxiety?’
Lin et al. [23]	cross-sectional observational	1. Online forum (the Professional Technology Temple)	1. Assessment based on DSM-5 criteria	-	1. Assessment based on DSM-5 criteria	APSA- everyday memory and concentration performance Dickman impulsivity inventory
Tsuji et al. [24]	cross-sectional observational	1. Online survey company (Cross Marketing Inc.)	1. Part A of ASRS-v1.1	1. AQ	1. PMDD scale	-
Kondo et al. [25]	retrospective observational	1. Electronic medical records at Dokkyo Medical University Saitama Medical Center, psychiatry department	1. ADHD-RS + assessment based on DSM-5 criteria	PARS + assessment based on DSM-5 criteria AQ**	1. PMDD scale	1. QIDS-depressive symptoms
Obaydi & Puri [26]	prospective observer-rated	1. Hospitals or homes for people with learning disability in the large catchment area of the Home Counties in the south of England, UK	-	1. Childhood autism disorder documented in medical records + assessment based on DSM-IV criteria	1. Observer-based rating scale based on DSM-IV criteria	-
Groenman et al. [19]	cross-sectional observational (part of a multi-cohort longitudinal study)	Mental health institutions (YOUZ (Leo Kannerhuis and SARR), GGZ Breburg, GGZe, Mondriaan, PsyQ, GGZ inGeest) across the Netherlands Social media (Twitter, LinkedIn, and Facebook) Advertisements of autism networks (Dutch Association for autism Persons on the autism spectrum Impuls https://impulsen-woortblind.nl/) Social network of researchers, research assistants, and students	1. ADHD-SR**	Reported clinical diagnosis based on DSM-IV or DSM-5 criteria AQ**	1. Premenstrual dysphoria questions from the M.I.N.I. Plus	MRS-menopausal symptoms SCL-90-depressive and anxiety symptoms

* Excluding questions about general/demographic characteristics

** Not used for group identification

ADHD- attention-deficit/hyperactivity disorder; ADHD-RS- ADHD Rating Scale; ADHD-SR- ADHD-self-report; APSA- Attention and Performance Self-Assessment; AQ- Autism-Spectrum Quotient; ASD- autism spectrum disorder; ASRS- Adult ADHD Self-Report Scale; DSM- Diagnostic and Statistical Manual of Mental Disorder; EPDS- Edinburgh Postnatal Depression Scale; GCS- Greene Climacteric Scale; MCTQ- Munich Chronotype Questionnaire; M.I.N.I. Plus- Neuropsychiatric Interview Plus version 5.0.0; MRS- Menopause Rating Scale; PARS- Pervasive Developmental Disorders-Autism Society Japan Rating Scale; PMDD- Premenstrual Dysphoric Disorder; PSST- Premenstrual Symptoms Screening Tool; SCL-90- Symptom Checklist-90; QIDS- Quick Inventory of Depressive Symptomatology;

Table 3.

Characteristics of reviewed studies and participant distribution by PMDD status.

Study	Age of participants (years)	Participants (n)	PMDD (n)	Non-PMDD (n)
Dorani et al. [20]	18–71	209	95	114
Broughton et al. [22]	18–34	564	n/s	n/s
Lin et al. [23]	Mean age in PMDD: 28.09 +/− 4.72 Mean age in non-PMDD: 27.98 +/− 4.83	108	58	50
Tsuji et al. [24]	20–44	2000	101	1899
Kondo et al. [25]	10–19	290	100*	190**
Obaydi & Puri [26]	18–45	62	28	34
Groenman et al. [19]	31–79	70	8	62

* Moderate or higher PMS

** Mild or lower PMS

ADHD- attention-deficit/hyperactivity disorder; ASD- autism spectrum disorder; n- number; n/s- not specified; PMDD- Premenstrual Dysphoric Disorder; PMS-Premenstrual Syndrome;

Table 4.

Distribution of the study sample across different diagnostic subgroups.

Study	ADHD + PMDD (n)		ADHD Only (n)		ASD + PMDD (n)	ASD Only (n)	ASD + ADHD + PMDD (n)	ASD + ADHD Only (n)	PMDD Only (n)	Non-PMDD/ASD/ADHD/ASD+ADHD (n)
Dorani et al. [20]	95		114		-	-	-	-	-	-
Broughton et al. [22]	32*	94**	70*	135**	-	-	-	-	30	275
Lin et al. [23]	16		6		-	-	-	-	42	44
Tsuji et al. [24]	35***		137***		17***	238***	7***	23***	42	1501
Kondo et al. [25]	15****		16*****		28****	42*****	11****	9*****	46****	123*****
Obaydi & Puri [26]	-		-		24****	2****	-	-	4******	32******
Groenman et al. [19]	-		-		4	24	-	-	4	38

* Self-reported ADHD diagnosis

** ASRS-based ADHD

*** Traits of neurodevelopmental disorder

**** Moderate or higher PMS

***** Mild or lower PMS

****** With learning disability

ADHD- attention-deficit/hyperactivity disorder; ASD- autism spectrum disorder; n- number; PMDD- Premenstrual Dysphoric Disorder;

References

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Articles in this issue

DOI: https://doi.org/10.2478/bgbl-2026-0003 | Journal eISSN: 2956-6851 | Journal ISSN: 0373-174X

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Language: English, Polish

Page range: 33 - 51

Accepted on: Apr 27, 2026

Published on: Jun 6, 2026

Published by: The Medical Library named after S. Konopka in Warsaw

In partnership with: Paradigm Publishing Services

Publication frequency: 2 issues per year

Keywords:

premenstrual dysphoric disorder,

PMDD,

attention-deficit hyperactivity disorder,

ADHD,

autism spectrum disorder,

ASD,

PMS

Related subjects:

Medicine,

Biomedical engineering

© 2026 Aleksandra Suchołbiak, Oskar Mikołajczyk, Karolina Baran, Aleksandra Serafin, published by The Medical Library named after S. Konopka in Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.

Volume 59 (2026): Issue 386 (June 2026)