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

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

Open Access
|Jun 2026

Figures & Tables

Characteristics of reviewed studies and participant distribution by PMDD status_

StudyAge of participants (years)Participants (n)PMDD (n)Non-PMDD (n)
Dorani et al. [20]18–7120995114
Broughton et al. [22]18–34564n/sn/s
Lin et al. [23]
  • Mean age in PMDD: 28.09 +/− 4.72

  • Mean age in non-PMDD: 27.98 +/− 4.83

1085850
Tsuji et al. [24]20–4420001011899
Kondo et al. [25]10–19290100*190**
Obaydi & Puri [26]18–45622834
Groenman et al. [19]31–7970862

DSM-5-TR criteria for PMDD

Diagnostic Criteria for PMDD
A- Timing of symptomsMajority of menstrual cycles that occurred in the preceding year.At least five symptoms must be present.
The final week before the onset of menses.
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 symptomsAt least one symptom must be present.
  • 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 symptomsAt least one symptom must additionally be present, to reach a total of five symptoms when combined with Criterion B.
  • 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 impairmentDistress.
Interference with work or school performance.
Interference with usual social activities
Interference with relationships with others.
E- Differential diagnosis and comorbidityThe symptoms must not simply be a worsening of an existing underlying disorder.
  • MDD

  • Panic Disorder

  • PDD*

  • Personality Disorders

PMDD may co-occur with any of these disorders.
F- ConfirmationProvisional DiagnosisConfirmed Diagnosis
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 causesSymptoms 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).

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

StudyType of the studyRecruitment SourceADHD AssessmentASD/Autistic Traits AssessmentPMDD AssessmentAdditional Assessment Tools*
Dorani et al. [20]cross-sectional observational1. PsyQ outpatient clinic for Adult ADHD in The Hague, The Netherlands1. 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 observational1. 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. PSSTEndorsing the questions:
  • ‘Has a clinician ever diagnosed you with depression?’

  • ‘Has a clinician ever diagnosed you with anxiety?’

Lin et al. [23]cross-sectional observational1. 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 observational1. Online survey company (Cross Marketing Inc.)1. Part A of ASRS-v1.11. AQ1. PMDD scale-
Kondo et al. [25]retrospective observational1. Electronic medical records at Dokkyo Medical University Saitama Medical Center, psychiatry department1. ADHD-RS + assessment based on DSM-5 criteria
  • PARS + assessment based on DSM-5 criteria

  • AQ**

1. PMDD scale1. QIDS-depressive symptoms
Obaydi & Puri [26]prospective observer-rated1. 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 criteria1. 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

Distribution of the study sample across different diagnostic subgroups_

StudyADHD + 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]95114------
Broughton et al. [22]32*94**70*135**----30275
Lin et al. [23]166----4244
Tsuji et al. [24]35***137***17***238***7***23***421501
Kondo et al. [25]15****16*****28****42*****11****9*****46****123*****
Obaydi & Puri [26]--24****2****--4******32******
Groenman et al. [19]--424--438
DOI: https://doi.org/10.2478/bgbl-2026-0003 | Journal eISSN: 2956-6851 | Journal ISSN: 0373-174X
Language: English
Page range: 33 - 51
Accepted on: Apr 27, 2026
Published on: Jun 6, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year

© 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.