Current evidence for the identification and management of premenstrual syndrome in women with intellectual disabilities: a systematic review
Bibliographic record
Abstract
Purpose Intellectual disability (ID) is prevalent in 1 per cent of the population. Premenstrual syndrome (PMS) affects up to 5 per cent of the general population of adult women. Identification of PMS is challenging in women with ID due to differences in communication. Management of PMS in the ID population requires careful consideration of baseline function, co-existing mental and physical health problems, drug interactions as well as complex ethical considerations. The paper aims to discuss this issue. Design/methodology/approach Prospero-registered systematic review (CRD42019119398) of papers exploring the diagnosis and management of patients with PMS and ID ( n =414). In total, 35 relevant titles were identified and 27 full text papers were assessed for eligibility, resulting in 10 studies for final qualitative analysis. Findings Ten original research papers were included. There are no standardised symptom criteria for diagnosis of PMS in women with ID. Studies relied on observer-reported data. All papers demonstrated higher rates of PMS in women with ID compared with the general adult population. Management was not standardised and varied between centres. Mainstays of treatment included non-steroidal anti-inflammatories, combined oral contraceptive pills and intramuscular progesterone. Newer evidence suggests levonorgestrel intrauterine systems may be appropriate. There was no quantitative method of establishing success of management. Practical implications A modified symptom diary should be used for diagnosis in this population. Differentiation between cyclical behavioural change due to pain vs mood disturbance remains challenging. Conservative, psychological and medical management should be the mainstay of treatment, with surgery considered in exceptional cases. Originality/value This paper demonstrates the current limited evidence for the management of PMS in women with a diagnosis of ID and offers an overview of the current options for managing these patients’ symptoms.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".