LETTERS TO THE EDITOR
We read with interest the two part article on Late Luteal Phase Dysphoric Disorder (LLPDD) by Dr. Gallant and her coworkers which recently appeared in this Journal. This diagnosis has generated much controversy, both in psychiatry and elsewhere. It is also the only psychiatric diagnosis requiring prospective daily selfreports for confirmation. Its controversial status and its unique method of confirmation have both contributed to its popularity as a condition requiring additional research. The DSM-IV Work Group on Late Luteal Phase Dysphoric Disorder recently reported the results of their analyses of the daily self-report data from 670 women evaluated for premenstrual complaints (1-3). As contributors to that effort, we were struck by several points of similarity between Dr. Gallant's report and ours, as well as some differences. In both her study and in ours, the majority of the women who received the provisional diagnosis failed to meet the prospective criteria for the diagnosis, regardless of the method used to score symptom change. Dr. Gallant believes this should "raise concern using any of these criteria as a standard of confirmation" (p. 177). This point is emphasized, in her view, by the fact that the proportion of women who met this standard among those with the provisional diagnosis was not significantly greater than the proportion of women in either of the control groups of women or, often enough, the men. This line of reasoning seems erroneous in our view. First, it would suppose that there is something unique about the retrospective, provisional diagnosis for LLPDD that makes it a more compelling retrospective diagnosis than that obtained by any other retrospective set of criteria. We know of no evidence to suggest this is Psychosomatic Medicine 54:723-728 (1992) 0033-3174/92/5406-0723S03.00/0 Copyright
We read with interest the two part article on Late Luteal Phase Dysphoric Disorder (LLPDD) by Dr. Gallant and her coworkers which recently appeared in this Journal. This diagnosis has generated much controversy, both in psychiatry and elsewhere. It is also the only psychiatric diagnosis requiring prospective daily selfreports for confirmation. Its controversial status and its unique method of confirmation have both contributed to its popularity as a condition requiring additional research. The DSM-IV Work Group on Late Luteal Phase Dysphoric Disorder recently reported the results of their analyses of the daily self-report data from 670 women evaluated for premenstrual complaints (1-3). As contributors to that effort, we were struck by several points of similarity between Dr. Gallant's report and ours, as well as some differences. In both her study and in ours, the majority of the women who received the provisional diagnosis failed to meet the prospective criteria for the diagnosis, regardless of the method used to score symptom change. Dr. Gallant believes this should "raise concern using any of these criteria as a standard of confirmation" (p. 177). This point is emphasized, in her view, by the fact that the proportion of women who met this standard among those with the provisional diagnosis was not significantly greater than the proportion of women in either of the control groups of women or, often enough, the men. This line of reasoning seems erroneous in our view. First, it would suppose that there is something unique about the retrospective, provisional diagnosis for LLPDD that makes it a more compelling retrospective diagnosis than that obtained by any other retrospective set of criteria. We know of no evidence to suggest this is Psychosomatic Medicine 54:723-728 (1992) 0033-3174/92/5406-0723S03.00/0 Copyright
