Abstract：
BACKGROUND: Premenstrual 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.
METHODS: We 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).
RESULTS: 44 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 %).
CONCLUSIONS: A small number of included studies used full DSM criteria in community settings.
CONCLUSIONS: The 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.
METHODS: We 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).
RESULTS: 44 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 %).
CONCLUSIONS: A small number of included studies used full DSM criteria in community settings.
CONCLUSIONS: The 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.
摘要：
背景：经前焦虑障碍的特征是症状局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，否则诊断是暂时的。我们旨在测量经前烦躁不安症的点患病率。
方法：我们搜索了使用MEDLINE的患病率研究，EMBASE,PsycINFO和PubMed。对于每一项研究，提取总样本量和病例数。使用随机效应荟萃分析和广义线性混合模型计算研究的患病率。通过荟萃回归和亚组分析探索异质性的潜在来源。预注册在PROSPERO（CRD42021249249）。
结果：包含48个独立样本的44项研究符合纳入标准，由50,659名参与者组成。确诊的合并患病率为3.2%（95%置信区间：1.7%-5.9%），临时诊断为7.7%（95%置信区间：5.3%-11.0%）。所有研究均存在高度异质性(I2=99%)。通过元回归确定的异质性来源是样本大陆(p<0.0001)，样本类型(基于社区，大学,高中)(p=0.007)，偏差风险(p=0.009)，和诊断方法(p=0.017)。使用确诊诊断将分析限制在基于社区的样本中，患病率为1.6％（95％置信区间：1.0％-2.5％）。异质性低(I2=26%)。
结论：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，使用确诊诊断的经前焦虑障碍的点患病率较低。依靠临时诊断的研究可能会人为地产生高患病率。
方法：我们搜索了使用MEDLINE的患病率研究，EMBASE,PsycINFO和PubMed。对于每一项研究，提取总样本量和病例数。使用随机效应荟萃分析和广义线性混合模型计算研究的患病率。通过荟萃回归和亚组分析探索异质性的潜在来源。预注册在PROSPERO（CRD42021249249）。
结果：包含48个独立样本的44项研究符合纳入标准，由50,659名参与者组成。确诊的合并患病率为3.2%（95%置信区间：1.7%-5.9%），临时诊断为7.7%（95%置信区间：5.3%-11.0%）。所有研究均存在高度异质性(I2=99%)。通过元回归确定的异质性来源是样本大陆(p<0.0001)，样本类型(基于社区，大学,高中)(p=0.007)，偏差风险(p=0.009)，和诊断方法(p=0.017)。使用确诊诊断将分析限制在基于社区的样本中，患病率为1.6％（95％置信区间：1.0％-2.5％）。异质性低(I2=26%)。
结论：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，使用确诊诊断的经前焦虑障碍的点患病率较低。依靠临时诊断的研究可能会人为地产生高患病率。
