A literature review of psychotic symptoms associated with the premenstruum.

The proposed DSM-III-R diagnostic category, Late Luteal Phase Dysphoric Disorder (LLPDD), is a severe form of premenstrual disturbance. Core symptoms include mood lability and dysphoria with no psychotic features. Yet transient psychotic symptoms during the late luteal phase and during menstruation have been noted in the literature for decades. Although good prospective data are lacking, patients with these disturbances may variably be subsumed under diagnostic categories of "atypical psychosis," "periodic psychosis," and "cycloid psychosis." In this article, several patients displaying premenstrual psychoses are described. A review of the literature on psychoses during the menstrual cycle as it relates to the diagnostic criteria for LLPDD follows.