A systematic review and meta-analysis on the comorbidity of premenstrual dysphoric disorder or premenstrual syndrome with mood disorders: prevalence, clinical and neurobiological correlates.

In 30 seconds

This systematic review and random-effects meta-analysis examined the co-occurrence of premenstrual dysphoric disorder or premenstrual syndrome (PMDD/PMS) with adult non-reproductive mood disorders in women. Of 39 included studies, 36 (n = 3646) contributed to pooled prevalence estimates. Across three diagnostic sampling strategies, pooled comorbidity rates ranged from 42% (95% CI: 30%, 55%) to 49% (95% CI: 38%, 60%). The review also synthesised evidence on clinical course and neurobiological correlates, but methodological heterogeneity and variable risk of bias were noted.

Key findings

• Across sampling strategies, pooled PMDD/PMS and mood-disorder comorbidity ranged from 42% (95% CI: 30%, 55%) to 49% (95% CI: 38%, 60%).
• Thirty-six studies, comprising n = 3646, contributed to the meta-analysis; the full review included 39 studies.
• The evidence base included studies of bipolar disorders, unipolar depressive disorders, and mixed mood-disorder samples.

Why it matters

The consistently high pooled comorbidity estimates indicate that premenstrual disorders and mood disorders frequently occur together in the studied populations. Recognising this overlap is relevant to clinical assessment and to understanding illness course, while the review’s synthesis also identifies a need for better evidence on characteristics specific to comorbidity.

What to keep in mind

The authors note methodological heterogeneity, variable risk of bias, reliance on cross-sectional designs, and provisional PMDD/PMS diagnoses.