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What is DRSP, and why is it important for PMDD Diagnosis and research?
What is DRSP, and why is it important for PMDD Diagnosis and research?

Keywords: Tracking. Diagnosis. Research. DSM Criteria.

IAPMD avatar
Written by IAPMD
Updated over a week ago

You may have seen the term ‘DRSP’ when learning about PMDD - DRSP = Daily Record of Severity of Problems.

In short - this means keeping a daily record over at least two menstrual cycles of your symptoms and noting the severity. This must be done throughout the month and not retrospectively (so the details must be completed on the day and not added back later from memory). This is really important as making ratings on the same day means the information is fresh in your mind - after the event, we can forget, or the memory can get skewed - especially if we are in distress or have extreme fatigue!

PMDD Diagnosis

To establish a diagnosis of PMDD consistent with the DSM-5 definition, we recommend using the Daily Record of Severity of Problems (DRSP; Endicott et al., 2006), a checklist of DSM-5 PMDD symptoms that can be rated for severity daily. You can find a free, printable version of this symptoms tracker to aid your diagnosis here. Many tracking apps do not yet use the DMS-5 PMDD criteria, so we would recommend using this paper version in terms of symptom tracking to gain a diagnosis.

PMDD Research

For valid measurement and diagnosis, researchers should use daily ratings that measure the items from the diagnosis outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) published by the American Psychiatric Association (APA). This is crucial to ensure that studies align with the multifaceted and multilevel diagnostic criteria for PMDD, which require many conditions to be met (content, cyclicity, severity, and chronicity) at various levels (symptoms, domains, cycles).

What happens in research when there is a failure to use daily symptom

ratings to diagnose PMDs? (e.g., when recruiting a sample of patients with PMDs for study)

This is an issue.

Retrospective (recalling symptoms from memory afterward)and prospective ratings (adding the occurrence/severity of symptoms on the day they occurred) frequently do not match.

In practice, this means that the MAJORITY of currently published papers titled with “PMS” or “PMDD” provide no reliable information and must be ignored by expert scientists once a review of the methods section reveals a lack of prospective diagnosis.

While some may consider retrospective ratings “good enough” or “still provides some useful information,” it is important to remember that there is a high false-positive rate.

About 60% of those identified as having PMDD on retrospective measures did not have PMDD when their daily ratings were inspected.

Such high false-positive bias findings skew quality research in this emerging field so it is vital to use DRSP when screening candidates for PMD research to ensure that patients in the study show cyclical changes in their symptoms.

If you would like to know more about conducting quality research in PMDD, read our Guide to Conducting Rigorous, Patient-Centered PMDD Research.

Added August 2023.

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