Development and validation of the Premenstrual Symptoms Impact Survey (PMSIS): a disease-specific quality of life assessment tool

Abstract

Objective: To develop and validate the Premenstrual Symptoms Impact Survey (PMSIS), a brief web-based instrument for evaluating the impact of premenstrual symptoms on health-related quality of life (HRQOL).

Methods: An item bank of 68 questions was administered to a nationally representative sample of 971 women using the web, aged 18-45, who experienced regular menstrual cycles in the past 3 months, were not currently pregnant or breastfeeding, and were not being treated or taking medications for depression-related disorders in the last 2 years. Item reduction was performed using forward stepwise linear regression of an overall symptom severity score onto item scores. Three standards were used to validate the instrument: (1) the American College of Obstetricians and Gynecologists retrospective diagnostic criteria for identifying participants "at risk" for clinically significant premenstrual syndrome (PMS), (2) the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders retrospective diagnostic criteria for identifying participants at risk for premenstrual dysphoric disorder (PMDD), and (3) the Medical Outcomes Study Short Form (SF-12) Health Survey.

Results: Six items met entry criteria in the model. Approximately 6.0% of the participants were identified as being at risk for PMDD, and 17.3% were identified as being at risk for clinically significant PMS. PMSIS scale score differed significantly between participants who were and were not at risk for PMDD/clinically significant PMS. PMSIS scale score also differed significantly between participants having either high, average, or low HRQOL as defined by SF-12 physical and mental component summary scores.

Conclusions: These results demonstrate that the PMSIS has excellent discriminative ability to detect differences in groups that are known to differ in terms of clinical criteria. The PMSIS can be used to educate consumers about the impact of their symptoms on QOL.