The purpose of this investigation was to obtain information about lifetime psychiatric diagnoses of women seeking treatment for premenstrual syndrome. The National Institute for Mental Health Diagnostic Interview Schedule (DIS) was administered to 223 women attending a premenstrual syndrome clinic. Rates of symptoms and psychiatric disorders were then compared with DIS data collected from an Epidemiologic Catchment Area (ECA) program community sample of 923 women in the same age group from the same geographic location. Women in the Premenstrual Syndrome Clinic sample met DIS/DSM-III criteria for dysthymia, phobia, obsessive-compulsive disorder, alcohol abuse/dependence, and drug abuse/dependence with a greater frequency than did women from the community sample. There appears to be much overlap between the symptoms for which women seek help from a specialty premenstrual syndrome clinic and symptoms related to several specific affective, anxiety, and substance abuse disorders. Further investigation is needed to determine whether premenstrual syndrome is strongly associated with DSM-III psychiatric diagnoses or whether current psychiatric classification systems are inadequate for differentiation.