Case report, 2003

What causes psychosis linked to the menstrual cycle in adolescents?

Two cases showed acute psychosis in the days before menstruation that came and went with each cycle. One improved with a hormonal contraceptive, and the other improved on its own. The link may involve anovulation, which means not having regular ovulation.

Early or limited evidence Two Israeli adolescent girls

What they did

Described two cases of Israeli adolescent girls who had psychosis linked to their menstrual cycle. Doctors did extensive medical tests to rule out other causes.

What they found

Both girls developed acute psychosis a few days before their period, which subsided after bleeding started, then returned again in the next cycle. One had anovulatory cycles. Psychiatric medications did not help either girl. One improved with a progesterone-estrogen contraceptive within several cycles. The other improved on her own within four cycles. After 2-3 years of follow-up, both had complete remission and did not need psychiatric medication.

What it means for you

Psychosis tied to the menstrual cycle in adolescents may be related to hormone level changes and irregular ovulation. Hormonal contraceptives may help, and symptoms can improve even without treatment. This is two cases, so we cannot know how common this is or what works best.

cases reported

cycles to remission in case 2

2-3

years of follow-up

About the study

Original title: Perimenstrual psychosis among female adolescents: two case reports and an update of the literature
Authors: Stein D, Blumensohn R, Witztum E
Journal: International journal of psychiatry in medicine
Year: 2003
Study design: Case report
What was tested: Progesterone-estrogen contraceptive (one case)
Read the paper: doi.org/10.2190/6e0c-52xc-ggwq-dpu4

Topics

Premenstrual syndrome (PMS)Menstrual psychosis Schizophrenia and psychosis Adolescents and young people

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