Anger in women with premenstrual dysphoric disorder: Its relations with premenstrual dysphoric disorder and sociodemographic and clinical variables Esra Soyda Akyol a, ⁎ , Emel Özge Karakaya Arısoy b , Ali Çayköylü c a Department of Psychiatry, Yenimahalle State Hospital, Ankara, Turkey b Department of Familiy Physician, Taşköprü State Hospital, Kastamonu, Turkey c Department of Psychiatry, Ankara Atatürk Training and Research Hospital, Ankara, Turkey Abstract Purpose: The aim of the present study was to investigate anger and anger levels in women meeting the criteria of Premenstrual Dysphoric Disorder and to determine the relation between anger levels and the severity of PMDD and other variables. Methods: 50 women meeting the criteria of Premenstrual Dysphoric Disorder and 50 healthy controls were included in the study. Sociodemographic, familial and reproductive period characteristics of the women participating in the study were recorded. All subjects were administered the State–Trait Anger Scale and Premenstrual Syndrom Scale scales. Results: A significant difference was found between the Premenstrual Dysphoric Disorder group and the healthy control group in terms of Premenstrual Syndrom Scale scores and anger sub scores. When the state trait anger scale scores were examined, it was seen that subscles had higher scores compared to healthy women. In Premenstrual Dysphoric Disorder group; there was a positive correlation between Premenstrual Syndrom Scale scores and trait anger, anger-in and anger control scores. Conclusions: Anger appears to be an important problem that makes life more difficult for subjects with Premenstrual Dysphoric Disorder. Wide-scale further studies focused on anger and its relation with Premenstrual Dysphoric Disorder are needed to develop ways of coping with anger in Premenstrual Dysphoric Disorder. Crown Copyright © 2013 Published by Elsevier Inc. All rights reserved. 1. Introduction Menstruation covers nearly 30–35 years of a woman’s life. It is a physiological cyclic process that occurs every month and may progress with alterations in the psyhological condition of individual. These alterations were expressed by several authors ranging from Hipocrates in 600 B.C. to Troutula of salerno in 11th century and by various aouthors in the Renaissance period. Some moderate and transient psychological and physical manifestations which arise just the week before menstruation are especially noteworthy. These manifestations include fatique, sleeplessness, breast tenderness and swelling, sweating in hand and foot, weight gain, headache, nausea, constipation or diarrhea and eating disorders. It is claimed that these symptoms appear approximately in three quarters of the women. In some women, these symptoms may be severe to impair work capacity, social and family relations, and school performance [1–3]. This clinical presentation, defined as Premenstrual Stress Syndrome by Frank in 1931, was renamed as (1994) “Premenstrual Dysphoric Disorder (PMDD)” in the Diag- nostic and Statistical Manual of Mental Disorders (DSM-IV- TR) and classified in the group of depressive disorders not otherwise specified [4–6]. For the diagnosis of PMDD, at least five of 11 symptoms mentioned in DSM-IV-TR should be present; functionality should be disturbed and symptoms should have been existing at least for two consecutive months. Anger, irritability and agressive behavior are the most frequent symptoms in such a presentation. Although anger is a universal emotion and has a significant place in our daily lives; experiences may vary Available online at www.sciencedirect.com ScienceDirect Comprehensive Psychiatry 54 (2013) 850 – 855 www.elsevier.com/locate/comppsych ⁎ Corresponding author. Yenimahalle Devlet Hastanesi, Psikiyatri Kliniği, Ankara, Türkiye. Tel.: +90 5063895962; fax: +90 3124256689. E-mail address: esra_akyol@hotmail.com (E. Soyda Akyol). 0010-440X/$ – see front matter. Crown Copyright © 2013 Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.comppsych.2013.03.013