Menstrual psychosis

Menstrual psychosis is a debated form of psychosis with a brief, sudden onset related to the menstrual cycle. The symptoms associated to it are dramatic and may include delirium, mania or mutism. Most psychiatrists do not recognise the condition.[1] Only 80 established cases are reported in medical literature and most of them were described by 19th century physicians.[1][2] There is evidence to suggest that it may be linked to postpartum psychosis.[1]

Definition

Menstrual psychosis is a rare form of severe mental illness, with the following characteristics:[1]

  • Sudden onset in a previously asymptomatic person.
  • Brief duration, with full recovery.
  • Psychotic symptoms that can include confusion or hallucinations, mutism and stupor, delusions, or manic state. These are distinct from premenstrual tension, premenstrual syndrome, premenstrual (late luteal phase) depression or dysphoric disorder or menstrual mood disorder.
  • Occurrence in rhythm with the menstrual cycle.

It shares clinical features with, and presents similarly to, postpartum psychosis.[1] Researchers Deuchar and Brockington proposed that a sudden drop in levels of estrogen in the brain could be the trigger for both conditions.[3]

Epidemiology

The condition is rare, with only 80 established cases reported in medical literature and incomplete evidence of a further 200.[1]

History

Abnormal behaviour linked to menstruation was first noticed in the 19th century and, as early as 1825, menstrual mood disorder was used to acquit a mother convicted of infanticide.[4] The first descriptions of psychosis appeared about 1850.[5] In 1902, forensic psychiatrist and sexologist Richard v. Krafft-Ebing published a monograph with many case descriptions and a temporal classification.[6]

References

  1. 1 2 3 4 5 6 Brockington IF (June 2011). "Menstrual psychosis: a bipolar disorder with a link to the hypothalamus". review. Current Psychiatry Reports. 13 (3): 193–7. doi:10.1007/s11920-011-0191-5. PMID 21424263.
  2. ↑ Brockington I (February 2005). "Menstrual psychosis". review. World Psychiatry. 4 (1): 9–17. PMC 1414712. PMID 16633495.
  3. ↑ Deuchar N, Brockington I (June 1998). "Puerperal and menstrual psychoses: the proposal of a unitary etiological hypothesis". review. Journal of Psychosomatic Obstetrics and Gynaecology. 19 (2): 104–10. doi:10.3109/01674829809048503. PMID 9638603.
  4. ↑ Hitzig JE (1827). "Mord in einem durch Eintreten des Monatsflusses herheifuehrten unfreien Zustande" [Murder in an unfree state due to the onset of the month's flow]. Zeitschrift für Criminal-rechts-pflege in den Preussischen Staaten (in German). 12: 239–331.
  5. ↑ de Boismont B (1851). "Recherches bibliographiques et cliniques sur la folie puerpérale, précédées d'un aperçu sur les rapports de la menstruation et de l'aliénation mentale" [Bibliographic and clinical research on puerperal madness, preceded by an overview of the reports of menstruation and insanity]. Annales Médico-psychologiques (in French). 2nd (3): 574–610.
  6. ↑ von Krafft-Ebing R (1902). Psychosis Menstrualis. Eine Klinisch-forensische Studie [Menstrual psychosis: A clinical forensic study] (in German). Stuttgart: Enke. ISBN 978-1-160-46052-1. OCLC 14799970.
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