In the late 1970s, however, the topic of irritability resurfaced in the medical literature. Articles on its definition and measurement appeared, followed in the 1990s, by a pair of articles on its heritability. PMDD is distinct as its primary syptoms include irritability, tension, and dysphoria, and the diagnostic criteria exclude other emotional disturbances, such as depression or anxiety or psychoses. The benefit of a reliable and valid instrument to assess irritable mood emerges from clinical presentations where irritability, and not depression or anxiety, is the primary presenting complaint. At the Women's Health Concerns Clinic, such presentations are frequent in women not only with premenstrual complaints, but also those with perinatal, and perimenopausal mood disturbances.
Controversy surrounds the measurement of irritabilty.
Four self-report rating scales of irritablity have been published since 1957, however, a number of problematic issues pertaining to content and construct validity have been elucidated. Moreover, the writings on irritability and women are scant. Our results underscore that the key aspects which comprise irritability as a phenomenon may be more specific and more extensive than those encompased by the existing scales, and that the responses suggest a very different type of mood disturbance compared with the criteria for DSM-IV depressive or anxiety disorders. In summary, the historical writings, a body of clinical evidence, the studies on PMDD, recently published case reports, and our early research results, taken together, suggest congruence with the notion of severe irritability as a distinct mood condition. This idea, a group of us posit, represents not an introduction, but rather a resurrection of a longstanding and familiar, yet elusive, phenomenon.