Bengi Deniz, Strawbridge Rebecca, Drorian Melisa, Juruena Mario F, Young Allan, Frey Benicio N, Yalin Nefize
Neuroscience Graduate Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
Mood Disorders Treatment and Research Centre and Women's Health Concerns Clinic, St Joseph's Healthcare Hamilton, Hamilton, Canada.
Br J Psychiatry. 2025 Jul 11:1-14. doi: 10.1192/bjp.2025.133.
Mood disorders are among the leading causes of disease burden worldwide, with 20-70% of affected individuals experiencing comorbid premenstrual disorders. This systematic review and meta-analysis investigated the comorbidity of premenstrual dysphoric disorder (PMDD) or premenstrual syndrome (PMS) with non-reproductive mood disorders.
We aimed to determine the pooled prevalence of PMDD/PMS with adult mood disorders, assess the impact of comorbidity on clinical course and summarise the associated neurobiological findings.
Eligible studies were identified through Embase, MEDLINE and APA PsycINFO from inception to 22 January 2024 (PROSPERO, no. CRD42021246796). Studies on women ('females') with diagnoses of PMDD/PMS and mood disorders were included. Risk of bias was assessed using National Institutes of Health quality assessment tools. A random-effects, pooled-prevalence meta-analysis was conducted using the Comprehensive Meta-Analysis software, categorising diagnostic sampling strategies as follows: mood disorders diagnosed first, PMDD/PMS diagnosed first or concurrent diagnoses. A narrative synthesis explored secondary outcomes, including illness course and biomarkers.
A total of 39 studies were included, with 36 of these ( = 3646) contributing to the meta-analysis. Seven studies focused on bipolar disorders, 18 on unipolar depressive disorders and 14 on mixed samples of bipolar and unipolar disorders. Random-effects pooled-prevalence meta-analyses showed consistently high comorbidity rates between PMDD/PMS and mood disorders, ranging from 42% (95% CI: 30%, 55%) to 49% (95% CI: 38%, 60%) across sampling strategies. Risk of bias varied, with methodological heterogeneity noted.
This review underscores high comorbidity rates between PMDD/PMS and mood disorders, regardless of sampling strategy, and highlights the need for research into clinical and neurobiological characteristics specific to this comorbidity. Limitations include study heterogeneity, reliance on cross-sectional designs and provisional PMDD/PMS diagnoses. Future research should address these gaps to inform diagnostic and therapeutic advancements tailored to this population.
情绪障碍是全球疾病负担的主要原因之一，20%至70%的受影响个体同时患有经前疾病。本系统评价和荟萃分析调查了经前烦躁障碍（PMDD）或经前综合征（PMS）与非生殖系统情绪障碍的共病情况。
我们旨在确定PMDD/PMS与成人情绪障碍的合并患病率，评估共病对临床病程的影响，并总结相关的神经生物学研究结果。
通过Embase、MEDLINE和APA PsycINFO数据库检索从建库至2024年1月22日的相关研究（PROSPERO注册号：CRD42021246796）。纳入对诊断为PMDD/PMS和情绪障碍的女性（“女性”）的研究。使用美国国立卫生研究院质量评估工具评估偏倚风险。使用综合荟萃分析软件进行随机效应合并患病率荟萃分析，将诊断抽样策略分为以下几类：先诊断情绪障碍、先诊断PMDD/PMS或同时诊断。叙述性综述探讨了次要结果，包括疾病病程和生物标志物。
共纳入39项研究，其中36项（n = 3646）纳入荟萃分析。7项研究聚焦双相情感障碍，18项聚焦单相抑郁障碍，14项聚焦双相和单相障碍的混合样本。随机效应合并患病率荟萃分析显示，PMDD/PMS与情绪障碍之间的共病率始终很高，在不同抽样策略下，共病率范围为42%（95%CI：30%，55%）至49%（95%CI：38%，60%）。偏倚风险各不相同，存在方法学异质性。
本综述强调了无论抽样策略如何，PMDD/PMS与情绪障碍之间的高共病率，并突出了对这种共病的临床和神经生物学特征进行研究的必要性。局限性包括研究异质性、对横断面设计的依赖以及PMDD/PMS诊断的临时性。未来的研究应填补这些空白，为针对该人群的诊断和治疗进展提供依据。
