Les perturbations psychologiques que connaît la femme durant la phase prémenstruelle sont très fréquentes et dans la plupart des cas mineures. Cependant, 3 à 8 % des femmes en souffrent sévèrement, nécessitant un support médical (trouble dysphorique prémenstruel). L'objectif de ce travail est d'évaluer la prévalence du trouble dysphorique de la phase lutéale tardive (TDPM) sur un seul cycle menstruel à partir d'un échantillon représentatif de la population générale de Casablanca. Parmi les 618 femmes interviewées dont l'âge est compris entre 20 et 50 ans, durant la période de l'étude, 310 femmes répondaient aux critères A, B, et C du DSM IV du TDPM, soit une prévalence de 50,2 %. Il faut signaler que le critère D de l'évaluation prospective n'a pas été appliqué, dans la mesure où l'on ne pouvait évaluer le trouble sur plusieurs cycles. L'âge moyen des femmes présentant le trouble était de 32,2 8 ans, avec des extrêmes allant de 20 à 50 ans ; 54,8 % (n = 170) étaient mariées, 33,9 % (n = 105) étaient célibataires. Plus des deux tiers (66,5 %, n = 139) des sujets avaient de 1 à 4 enfants et 20,1 % (n = 85 ) d'elles en avaient plus. Dans cette étude, 73,9 % (n = 229) des femmes rapportaient avoir des perturbations au niveau de leurs relations familiale, conjugale et professionnelle secondaires aux perturbations psychologiques survenant durant la phase prémenstruelle. Ces résultats confirment ceux d'autres études dans ce domaine. Une intention particulière doit être donnée au traitement de cette forme clinique pour améliorer la qualité de vie de ces femmes qui souffrent de cette affection.

Menstruation is a biological phenomenon that has been subject of myths and taboos within and among various cultures. These myths distort the reality surrounding menstruation and create ambivalent feelings about the value and usefulness of this function outside of its necessity as mean of reproduction. Thus studies concerning menstruation need to take into account cultural and psychosocial factors that define the meaning, values and behavior associated with this biological phenomenon. According to several studies, 70 % of women experience psychological faintness during this menstrual phase, 40 % of them have these symptoms at each menstruation and between 3 to 8 % of them suffer severely reacquiring medical support. This entity called premenstrual dysphoric disorder is defined by the presence of several symptoms (distress, tension, irritability, moodiness…) with a significant impairment in work or social functioning beginning during the week before and ending within a few days after the onset of menses. Several studies conducted over the past few years suggested that selective serotonin reuptake inhibitors (SSRIs) and serotoninergic tricyclic drugs may be more effective than other types of antidepressants in treating PMS symptoms. Two protocols are proposed ; a continuous treatment or intermittent use during few days during pre-menstrual and menstrual phase for several cycles. The objective of the current study was to evaluate the prevalence of a potential premenstrual dysphoric disorder (PMDD) during one menstrual cycle, in a representative sample of general population of Casablanca, according the DSM IV criteria. On the other hand, a questionnaire, available from the authors, was used to explore socio-demographic data. Among 618 women interviewed, 310 met the criteria of a potential PMDD (50.2 %). The mean age of the population with PMDD was 32.2 8 years ranging from 20 to 50 years ; 54.8 % of them were married, 33.9 % of them were single and 66.5 % of them had between 1 to 4 children. Two third of them were without a professional activity. During this premenstrual phase the following symptoms were found among the whole sample : marked depressive mood, feeling of hopelessness, or self-depreciation thoughts (77.7 %, n = 241 %) ; difficulty of concentration (65 %, n = 201) ; marked change in appetite, overeating or specific food craving (82.8 %, n = 256) ; marked affective lability, with sadness tearful and increased sensitivity to rejection (65.8 %, n = 204) ; hypersomnia or insomnia (59.7 %, n = 185) ; subjective sense of being overwhelmed or out of control (55.7 %, n = 172) ; lethargy, excessive fatigability (91.6 %, n = 283) ; physical symptoms including breast tenderness, swelling, headache, joint or muscular pain, and a sensation of « bloating » and weight gain (81.9 %, n = 253). The most severe symptoms were fatigue and irritability. On the other hand, 73.9 % of the sample had a disturbance in their socio-professional lives as a consequence to the psychological disturbances. Half of these women consulted a physician, mostly a general practitioner. These data are in accordance with the literature, confirming that this disorder is common and has a bad impact on mental health and on quality of life of the women suffering from PMDD.