The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis
The prevalence of premenstrual dysphoric disorder: Systematic review and meta-analysis
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经前焦虑障碍的患病率：系统回顾和荟萃分析
DOI：
10.1016/j.jad.2024.01.066
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发表时间：
2024
影响因子：
6.6
通讯作者：
Reilly T
中科院分区：
文献类型：
--
作者：
Reilly T
背景经前烦躁障碍的特征是症状仅限于月经周期的经前阶段。确诊需要在两个周期内对症状进行前瞻性监测，否则诊断是临时的。我们的目的是测量经前焦虑障碍的点患病率。方法我们使用 MEDLINE、EMBASE、PsycINFO 和 PubMed 检索患病率研究。对于每项研究，提取总样本量和病例数。研究中的患病率是使用随机效应荟萃分析和广义线性混合模型来计算的。通过荟萃回归和亚组分析探讨了异质性的潜在来源。预注册是通过 PROSPERO (CRD42021249249) 进行的。结果 44 项研究涉及 48 个独立样本，符合纳入标准，共有 50,659 名参与者。确诊的汇总患病率为 3.2%（95% 置信区间：1.7%–5.9%），临时诊断的汇总患病率为 7.7%（95% 置信区间：5.3%–11.0%）。所有研究都存在高度异质性 (I2= 99%)。通过元回归确定的异质性来源包括样本大陆 (p< 0.0001)、样本类型（社区、大学、高中）(p=0.007)、偏倚风险 (p=0.009) 和诊断方法 (p=0.017)。将使用确诊的分析限制在基于社区的样本，导致患病率为 1.6%（95% 置信区间：1.0%–2.5%），异质性较低 (I2=26%)。 局限性 少数纳入的研究在社区环境中使用了完整的 DSM 标准。结论与临时诊断相比，使用确诊的经前烦躁障碍的点患病率较低。依赖临时诊断的研究可能会人为地产生高患病率。
BackgroundPremenstrual dysphoric disorder is characterised by symptoms confined to the premenstrual phase of the menstrual cycle. Confirmed diagnosis requires prospective monitoring of symptoms over two cycles, otherwise the diagnosis is provisional. We aimed to measure the point prevalence of premenstrual dysphoric disorder.MethodsWe searched for studies of prevalence using MEDLINE, EMBASE, PsycINFO and PubMed. For each study, the total sample size and number of cases were extracted. The prevalence across studies was calculated using random effects meta-analysis with a generalised linear mixed model. Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Pre-registration was with PROSPERO (CRD42021249249).Results44 studies with 48 independent samples met inclusion criteria, consisting of 50,659 participants. The pooled prevalence was 3.2 % (95 % confidence intervals: 1.7 %–5.9 %) for confirmed and 7.7 % (95 % confidence intervals: 5.3 %–11.0 %) for provisional diagnosis. There was high heterogeneity across all studies (I2= 99 %). Sources of heterogeneity identified by meta-regression were continent of sample (p< 0.0001), type of sample (community-based, university, high school) (p= 0.007), risk of bias (p= 0.009), and method of diagnosis (p= 0.017). Restricting the analysis to community-based samples using confirmed diagnosis resulted in a prevalence of 1.6 % (95 % confidence intervals: 1.0 %–2.5 %), with low heterogeneity (I2= 26 %).LimitationsA small number of included studies used full DSM criteria in community settings.ConclusionsThe point prevalence of premenstrual dysphoric disorder using confirmed diagnosis is lower compared with provisional diagnosis. Studies relying on provisional diagnosis are likely to produce artificially high prevalence rates.