Amenorrhea in Psychiatric Inpatients

Flint, Nora B.

doi:10.1001/archpsyc.1983.01790050115021

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Our search identified 1197 records, 50 of which met the inclusion criteria for qualitative and 31 for quantitative synthesis (Figure 1). Thirty of the latter ascertained individuals according to reproductive diagnosis status (affected or unaffected) and evaluated rate of psychiatric morbidity within those groups.…”

Section: Resultsmentioning

confidence: 99%

“…Our search identified 1197 records, 50 8 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 of which met the inclusion criteria for qualitative and 31 8 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 46 ,…”

Section: Resultsunclassified

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Association Between Mental Health and Reproductive System Disorders in Women

et al. 2023

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ImportanceReproductive system and mental health disorders are commonly comorbid in women. Although the causes of this overlap remain elusive, evidence suggests potential shared environmental and genetic factors associated with risk.ObjectiveTo investigate the comorbidity between psychiatric and reproductive system disorders, both as broad diagnostic categories and among specific pairs of diagnoses.Data SourcePubMed.Study SelectionObservational studies published between January 1980 and December 2019 assessing prevalence of psychiatric disorders in women with reproductive system disorders and prevalence of reproductive system disorders in women with psychiatric disorders were included. The study did not include psychiatric and reproductive disorders triggered by life events (eg, trauma, infection, surgery) to address potential confounding.Data Extraction and SynthesisA search yielded 1197 records, of which 50 met the inclusion criteria for the qualitative and 31 for the quantitative synthesis in our study. A random-effects model was used for data synthesis and Egger test and I2 to assess study bias and heterogeneity. Data were analyzed from January to December 2022. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline.Main Outcomes and MeasuresPsychiatric and reproductive system disorders.ResultsA total of 1197 records were identified, of which 50 met the inclusion criteria for qualitative and 31 for quantitative synthesis. Diagnosis of a reproductive system disorder was associated with a 2- to 3-fold increased odds of having a psychiatric disorder (lower bound odds ratio [OR], 2.00; 95% CI, 1.41-2.83; upper bound OR; 2.88; 95% CI, 2.21-3.76). The analysis focused on specific diagnoses described in the literature and found that polycystic ovary syndrome was associated with increased odds of depression (population-based studies OR, 1.71; 95% CI, 1.19-2.45; clinical studies OR, 2.58; 95% CI, 1.57-4.23) and anxiety (population-based studies OR, 1.69; 95% CI, 1.36-2.10; clinical studies OR, 2.85; 95% CI, 1.98-4.09). Chronic pelvic pain was also associated with both depression (OR, 3.91; 95% CI, 1.81-8.46) and anxiety (OR, 2.33; 95% CI, 1.33-4.08). Few studies investigated risk of other reproductive system disorders in women with psychiatric disorders, or reverse associations (risk of reproductive system disorder among women with a psychiatric diagnosis).Conclusions and RelevanceIn this systematic review and meta-analysis, a high rate of reported co-occurrence between psychiatric and reproductive disorders overall was observed. However, data for many disorder pairs were limited. The available literature focused overwhelmingly on affective disorders in polycystic ovary syndrome, overlooking a substantial portion of disease overlap. As such, the associations between the majority of mental health outcomes and conditions of the female reproductive system are largely unknown.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsunclassified

Association Between Mental Health and Reproductive System Disorders in Women

et al. 2023

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“…Women’s lower dosage requirements may be due to the neuroleptic-enhancing properties of estrogen. The effect may be missed clinically because high doses of neuroleptics interfere with the hypothalamic-pituitary-ovarian axis and women given high neuroleptic doses may not be producing estrogens (Flint and Stewart 1983). It is therefore important to determine the endocrine status of women before male/female dose comparisons can be interpreted.…”

Section: Activational Effects Of Adolescent Sex Hormonesmentioning

confidence: 99%

The Role of Estrogens in Schizophrenia Gender Differences

Seeman

Lang

1990

Schizophrenia Bulletin

392

190

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The male/female differences that have been described in schizophrenia are important because they may ultimately shed light on factors that mediate the expression of schizophrenic illness. The hypothesis of this article is that estrogens, either directly or indirectly, modify symptom expression and account for many of the observed gender differences. The role of sex hormones is divided into organizational and activational effects. Organizational effects take place during a critical period in fetal life and put a permanent stamp on the developing brain. Activational effects are the direct influences of circulating hormones that appear when hormonal levels rise, and wane when hormonal levels drop. Because levels of sex hormones in adult women fluctuate during the menstrual cycle, cyclic effects of high and low female hormones may induce specific responses by the adult female brain. All these effects have implications for genetic, environmental, pharmacological, neurocognitive, clinical, and epidemiological research in schizophrenia.

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