Introduction: Premenstrual dysphoric disorder (PMDD) is characterized by cyclical affective, cognitive, and somatic symptoms that occur during the late luteal (LL) phase. The primary objective of this study was to investigate changes in affective symptoms, emotional regulation, and psychological resilience across different menstrual phases in women with PMDD compared with healthy controls. Our secondary objective was to determine how comorbid emotional disorders and baseline psychological resilience moderate these patterns. Methods and Materials: A total of 58 women with PMDD and 50 healthy controls were examined during three menstrual phases: the preovulatory phase, midluteal phase, and LL phase. The study used various instruments to evaluate depression, anxiety, emotional regulation (Affective Style Questionnaire), and psychological resilience (14-item Resilience Scale) in the participants. Diagnostic interviews identified comorbid major depressive disorder and generalized anxiety disorder. Results: The results revealed that compared with the control group, the PMDD group exhibited significantly higher depression and anxiety levels across all phases, with peak symptoms during the LL phase. Emotional regulation and psychological resilience significantly declined during the LL phase. Women with both PMDD and comorbid emotional disorders exhibited persistently stronger affective symptoms and lower psychological resilience. Higher psychological resilience was correlated with lower depression and anxiety. Conclusion: PMDD involves phase-dependent emotional dysregulation and reduced psychological resilience, particularly during the LL phase. Emotional comorbidities exacerbate baseline affective vulnerability. Enhancing emotional regulation and psychological resilience may represent a key therapeutic target for improving emotional stability and quality of life in women with PMDD.
Lin et al. (2026) studied this question.