Perimenstrual Psychosis among Female Adolescents: Two Case Reports and an Update of the Literature

Objectives and Methods: Perimenstrual psychosis is an uncommon disorder, not included under the accepted classifications of functional psychoses. Our aim was to describe two Israeli female adolescents who fit this diagnosis. Results: Both youngsters developed an acute psychosis a few days before men...

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Bibliographic Details
Published in:International journal of psychiatry in medicine 2003-01, Vol.33 (2), p.169-179
Main Authors: Stein, Daniel, Blumensohn, Rachel, Witztum, Eliezer
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult and adolescent clinical studies
Antipsychotic Agents - therapeutic use
Biological and medical sciences
Case reports
Drug Combinations
Drug Tolerance
Estrogens - therapeutic use
Female
Humans
Medical sciences
Nosology. Terminology. Diagnostic criteria
Other psychotic disorders
Premenstrual Syndrome - drug therapy
Premenstrual Syndrome - psychology
Progesterone - therapeutic use
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychoses
Psychosis
Psychotic Disorders - drug therapy
Psychotic Disorders - psychology
Techniques and methods
Teenagers
Treatment Outcome
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Summary:Objectives and Methods: Perimenstrual psychosis is an uncommon disorder, not included under the accepted classifications of functional psychoses. Our aim was to describe two Israeli female adolescents who fit this diagnosis. Results: Both youngsters developed an acute psychosis a few days before menstruation, which subsided several days after bleeding, only to reappear in the same form in subsequent cycles. An extensive medical work-up did not show any significant disturbances, with the exception of anovulatory cycles in one youngster. Psychotropic treatment had no effect on the course of the psychosis. Treatment with a combined progesterone/estrogen contraceptive agent in one patient resulted in full recovery within several cycles. The second patient showed a spontaneous remission within four cycles. Follow-up for two to three years indicated a complete remission, with no need to reintroduce any psychotropic agent. Conclusions: Perimenstrual psychosis may represent a cycloid disorder or an atypical affective disorder, associated with anovulation. The use of psychotropic treatment is considered inconclusive, whereas hormonal agents may prove effective.
ISSN:0091-2174
1541-3527
DOI:10.2190/6E0C-52XC-GGWQ-DPU4