Introduction
The Premenstrual Symptoms Screening Tool (PSST) is a simple, 19-item screening tool that identifies women with severe premenstrual symptoms consistent with premenstrual dysphoric disorder (PMDD) and women with clinically significant premenstrual syndrome (PMS). M. Steiner, M. Macdougall and E. Brown published it in 2003, and it has received more than 970 citations.
The PSST rates symptom severity and how much the symptoms interfere with daily life. This guide explains its items, scoring, translations and evidence.
Key Features of the Premenstrual Symptoms Screening Tool (PSST)
Purpose and Use
The PSST assesses premenstrual symptom severity and related functional impairment. It helps identify women who may benefit from treatment and guides further clinical assessment.
Target Population
The PSST is intended for adult women of reproductive age, aged 18 to 55, who have premenstrual symptoms. It was first evaluated in a primary care setting.
Structure
The PSST has 19 items:
14 symptom items: depressed mood; anxiety or tension; tearfulness or sensitivity to rejection; anger or irritability; less interest in work, home or social activities; difficulty concentrating; fatigue; overeating or food cravings; insomnia; hypersomnia; feeling overwhelmed or out of control; and physical symptoms5 impairment items: interference with work efficiency or productivity, relationships with coworkers, family relationships, social activities and home responsibilitiesScoring Method
All items are rated on a 4-point severity scale: not at all, mild, moderate or severe.
Symptom presence: in the original study, a symptom counted as present when rated moderate or severe, and absent when rated not at all or mild.Classification: symptom severity and functional impairment are used together to classify respondents into three groups: PMDD, moderate-to-severe PMS and no or mild PMS.No numeric cut-off scores are reported.
Administration Format
The PSST takes about 5–10 minutes and needs no training. It can be given on paper, online, in person or by phone or video.
Applications of the Premenstrual Symptoms Screening Tool (PSST)
The PSST supports several uses:
Screening: identifying possible PMDD and clinically significant PMS.Clinical assessment: identifying women who may benefit from further assessment and treatment.Research: classifying participants by premenstrual symptom severity.Languages and availability
The PSST has been translated and validated in many languages:
Arabic: validation and cultural adaptationChinese: reliability and validityGerman: SIPS, the German versionBrazilian Portuguese: validation and quality of lifePersian: Iranian validationItalian: validation studySerbian: translation, adaptation and validationThe PSST is proprietary, with copyright licensing through McMaster University, so permission is needed. A copy of the tool is available online.
Reliability and Validity
The PSST is considered highly reliable and valid in translated versions, with Cronbach's alphas of 0.89 (Italian), 0.93 (Iranian) and 0.91 (Brazilian Portuguese). The original study showed clinical feasibility but did not establish full psychometric validity against prospective daily symptom ratings.
Validation studies:
The premenstrual symptoms screening tool (PSST) for clinicians (2003): study linkPMDD in Arab women: validation of the Arabic PSST (2019): study linkValidation of the Brazilian Portuguese PSST (2017): study linkThe Iranian version of the PSST (2013): study linkLimitations and Considerations
Keep these points in mind:
Screening only: a positive result should prompt further clinical assessment, not be treated as a diagnosis.Retrospective: the original study did not validate it against prospective daily symptom ratings.Self-report and narrow focus: it covers premenstrual symptoms only, in women aged 18–55.Permission: use requires permission through McMaster University.Other Versions And Related Questionnaires
The Premenstrual Symptoms Screening Tool for Adolescents (PSST-A) is an adolescent version.
These questionnaires are related:
Daily Record of Severity of Problems (DRSP)Calendar of Premenstrual Experiences (COPE)Additional Resources
The original article: linkFor inquiries, contact Meir Steiner, MD, PhD, FRCPC, at mst@mcmaster.ca.Browse more obstetrics and gynecology questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Premenstrual Symptoms Screening Tool measure?The PSST measures the severity of 14 premenstrual symptoms and how much they interfere with work, relationships, social activities and home life, to screen for PMDD and clinically significant PMS.
How is the PSST scored?Items are rated not at all, mild, moderate or severe. Symptoms rated moderate or severe count as present, and severity plus impairment classify women as PMDD, moderate-to-severe PMS, or no or mild PMS.
Can the PSST diagnose PMDD?No. The PSST is a screening tool. A positive result should prompt further clinical assessment rather than be treated as a definitive diagnosis of PMDD or PMS.
Is there a PSST for adolescents?Yes. The Premenstrual Symptoms Screening Tool for Adolescents (PSST-A) is a version of the tool adapted for adolescents.
A Word from ResRef About the Premenstrual Symptoms Screening Tool (PSST)
The PSST is a brief, clinician-friendly screening questionnaire designed to identify women experiencing clinically significant premenstrual symptoms and functional impairment. It was originally evaluated in women aged 18–55 years in a primary care setting and provides a practical starting point for identifying possible PMS and PMDD. The original study demonstrated clinical feasibility but did not establish comprehensive psychometric validity against prospective daily symptom ratings. Positive screening results should therefore prompt further clinical assessment rather than be treated as a definitive diagnosis.
References
Steiner, M., Macdougall, M., & Brown, E. (2003). The premenstrual symptoms screening tool (PSST) for clinicians. Archives of Women's Mental Health, 6(3), 203–9. https://doi.org/10.1007/s00737-003-0018-4Mahfoud, Z., Emam, R., Anchassi, D., Omran, S., Alhaj, N., Al-Abdulla, S., El-Amin, A., Shehata, M., Aly, S., Al Emadi, N., Al-Meer, F., & Al-Amin, H. (2019). Premenstrual dysphoric disorder in Arab women: Validation and cultural adaptation of the Arabic version of the premenstrual screening tool. Women & Health, 59(6), 631–645. https://doi.org/10.1080/03630242.2018.1539433Câmara, R. D. A., Köhler, C. A., Frey, B. N., Hyphantis, T. N., & Carvalho, A. F. (2016). Validation of the Brazilian Portuguese version of the Premenstrual Symptoms Screening Tool (PSST) and association of PSST scores with health-related quality of life. Revista Brasileira de Psiquiatria, 39(2), 140–146. https://doi.org/10.1590/1516-4446-2016-1953Hariri, F. Z., Moghaddam-Banaem, L., Siah Bazi, S., Saki Malehi, A., & Montazeri, A. (2013). The Iranian version of the Premenstrual Symptoms Screening Tool (PSST): a validation study. Archives of Women's Mental Health, 16(6), 531–7. https://doi.org/10.1007/s00737-013-0375-6Bentz, D., Steiner, M., & Meinlschmidt, G. (2012). [SIPS--screening instrument for premenstrual symptoms. The German version of Premenstrual Symptoms Screening Tool to assess clinically relevant disturbances]. Der Nervenarzt, 83(1), 33–9. https://doi.org/10.1007/s00115-010-3210-6Pacitti, F., Iorio, C., Riccobono, G., Iannitelli, A., & Pompili, A. (2021). Assessment of premenstrual symptoms: validation of the Italian version of the Premenstrual Symptoms Screening Tool. Rivista Di Psichiatria, 56(5), 246–253. https://doi.org/10.1708/3681.36672Li, X., & Wang, X. (2026). Reliability and Validity of the Chinese Version of the Premenstrual Symptoms Screening Tool. Brain and Behavior, 16(5). https://doi.org/10.1002/brb3.71455Mihajlovic, D., Dunjic, M., Sulovic, N., Vitkovic, L., Brajovic Car, K., Anicic, R., Kocic, J., Milijevic, N., Milic, M., & Dotlic, J. (2026). Translation, Cultural Adaptation, and Psychometric Validation of the Premenstrual Symptoms Screening Tool (PSST) in Serbian. Diagnostics, 16(10), 1564. https://doi.org/10.3390/diagnostics16101564