User talk:Alabrutto/sandbox/My sandbox

Latest comment: 5 years ago by Cjs22

Section 1 - Premenstrual Dysphoric Disorder: “The exact pathogenesis of the disorder is still unclear and is an active research topic” – Maybe you can include a review of the techniques/experiments being done to discover the pathogenesis. It might not be as detailed as some more established disorders, but it could be a good way of establishing an etiology section. The etiology section might not be as detailed as it is in the articles of other disorders, but readers might be interested in our early understanding of the disorder’s mechanisms.

“Treatment of PMDD relies largely on antidepressants that modulate serotonin levels in the brain.:” – I know SSRI treatment is more detailed later in the treatment section, but is this masking a symptom or is it related to the mechanism of the disease? You might be able to specify this using one of the sources from the diagnosis sections.

Section 2 – Signs and Symptoms: “The most debilitating symptoms are emotional and include "irritability, depression, mood lability, anxiety, feelings of ‘loss of control’, difficulty concentrating and fatigue."[1] The physical symptoms include "abdominal bloating, breast tenderness, headache and generalized aches."[1]” – You commented on this portion that things shouldn’t be quoted on Wikipedia, you’re right. Also, you can link these symptoms to the epidemiology section. You might be able to include the relative prevalence of the symptoms without mentioning the individual percentages of populations (unlike the actual epidemiology section). This could give the reader a more detailed and specific understanding of the disorder (e.g. which components are more fundamental to the disorder – similar to the diagnostic criterion section of the article).

Section 3 – Diagnosis: Overall a detailed section. It might be beneficial to include wiki-links to the individual criteria. Something that could enhance the section could be literature involving debate between the criteria (e.g. debates about what constitutes the disorder or discussion about whether certain criterion should be required, removed, or added for/to the diagnosis). Perhaps you can find the discussion that changed the international classification of Diseases.

Section 4 – Treatment: “Women taking SSRIs to ease PMDD generally report>50% alleviation in symptoms, which was significant improvement compared to a placebo. [21]” – You might want to include where the report is from, different demographics might have environmental influences, social differences that might influence this report. “Another FDA approved treatment for PMDD is the oral contraceptive with ethinylestradiol and drospirenone (a novel progestin) taken on a 24-4 schedule (24 active pills, 4 inactive pills).[20]” – You can add a review of the efficacy for this, the same way it was provided for SSRIs. “Another treatment, typically used when other options have failed, is injection of a gonadotropin-releasing hormone agonist.[26] These drugs create a temporary, drug-induced menopause-like condition. Addback of estradiol is recommended to prevent bone loss long-termin the long-term; this generally necessitates the concurrent addback of progesterone to prevent estradiol-induced endometrial hyperplasia.” – How often do doctors have to resort to this treatment? Is there relevant statistical information to give the reader more back-ground on when/how often the treatment might occur. “In 1998, a placebo-controlled, randomized trial of 720 women with PMDD found that calcium carbonate demonstrated up to a 50% reduction in symptoms, compared with a 30% reduction in the control group.[31][32]” – What kind of symptoms were alleviated with this treatment. This type of information could outline the primitive mechanistic understanding of the disorder that we currently have.

Section 5 – Relationship with Pregnancy: “Although one might expect a higher rate of postpartum depression among those with PMDD;[36] however, a large study of women with prospectively-confirmed PMDD did not find a higher prevalence of postpartum depression than in controls.[37]” - Maye you can include the country that the study was done in, the environment might provide some background.

Section 6 – History: “The diagnostic category was discussed in the DSM-IIIR, published in (1987), in which the proposed condition was named "Late Luteal Phase Dysphoric Disorder" and was included in thean appendix as a proposed diagnostic category needing further study. Preparations for the DSM-IV led to debate about whether to keep the category at all, only keep it in the appendix, or remove it entirely; the reviewers determined that the condition was still too poorly studied and defined, so it was kept in the appendix but elaborated with diagnostic criteria to aid further study.[38]” – Is there any commentary on its listing in the DSM 5? How does the rest of the world view the disorder? Is there a difference between countries in the debate of whether if it is “unnecessary pathologizing” or if it is important to consider as a disorder?

Overall: Good consistent edits in making the language more gender neutral. The article is nicely organized with a lot of information in each section. Some of the sections are more detailed than others. Nice work in pointing out the writing style of the previous authors, there was some unnecessary language that doesn’t make this page seem like a Wikipedia article, redundancy, etc. I think you would do well in writing about various associations acknowledging the disorder. There are implications for considering these symptoms as a unique disorder in addition to the implications of not acknowledging PMDD as a unique disorder. Both of these scenarios uniquely affect women – I could envision a sociological section being added to this article. This is touched upon on the article, but I think you could paraphrase and highlight this topic very well.

Cjs22 (talk) 18:50, 25 March 2019 (UTC)Cjs22Reply