Menstruation and Acute Psychiatric Illnesses

Abstract

This investigation was undertaken to determine whether acute psychiatric admissions to hospital were in any way influenced by the premenstruum or by menstruation. For many years it has been believed that psychiatric illness was apt to exacerbate at the time of the menstrual period, and in this paper an attempt is made to determine if such a relationship exists. It has been prompted by the recognition of the premenstrual syndrome and its successful treatment (Greene and Dalton, 1953).As there are many ways in which the acutely ill can be admitted to hospital it was decided to examine admission records of two large mental hospitals (2,470 and 2,290 beds) and the mental observation ward of a London teaching hospital, and to confine the investigation to those patients whose illness was so acute that immediate admission was sought. This meant that patients who were admitted when a bed vacancy occurred were excluded, as were those admitted through an out-patient clinic. By this means the investigation was restricted to those whose admission was obtained because of the acuteness of their illness at the time of admission.The sister in charge of admissions recorded the date of the patient's last menstrual period at the time of her admission. The data were obtained from statements of patients suffering from a variety of psychiatric illnesses and excluding those too ill to give reliable information. All patients with amenorrhoea exceeding 28 days were excluded.Results For the interpretation of results the 28 days of the menstrual cycle were divided into seven four-day periods, in which days 1-4 corresponded to menstruation, days 13-16 covered ovulation, and days 25-28 the premenstruum. It was recognized that menstruation may exceed four days, but the full menstrual flow with relief of water retention usually occurs during the first four days. The relative incidence rate represents the number of actual admissions during a four-day period compared with the expected number of admissions during a four-day period (or one-seventh of total admissions). Fig. 1 gives the time in the menstrual cycle of psychiatric admissions for 276 patients and shows that the expected rate of admissions is doubled during menstruation. Fig. 2 gives the time of admissions of 36 attempted suicides and shows a relative incidence rate during menstruation of 2.75 or 39%. This figure of 39% of attempted suicides during menstruation compares with the figure of 36% reported by Heller in 1900, 22%by Ollerdorf in 1905, and 33% by Slavik in 1910 (quoted by Gregory, 1957, and supports the findings of MacKinnon and MacKinnon (1956) that successful suicides seem commoner during the luteal phase. Figs. 3 and 4 show that admissions during menstruation are greatly increased both for 185 patients with depression and for 114 patients with schizophrenia.The influence of menstruation on psychiatric admissions was evenly distributed among single, married, and widowed; among nulliparous and multiparous; and among those admitted for first and for recurrent attacks. The...

Schizophrenia: do men and women suffer from the same disease?

“…From this we concluded that oestrogen also has a weak neuroleptic-like effect on schizophrenic symptoms. An analogous variation in symptom severity over the menstrual cycle was also reported by Hallonquist et al (1993), and similar clinical observations had previously been published by Dalton (1959) and Endo et al (1978). Seeman and Cohen (1999), early proponents of the oestrogen hypothesis, tested the hypothesis that an earlier onset of functional oestrogen secretion with puberty might be associated with a later onset of schizophrenia in women.…”

Early Visual Processing over the Menstrual Cycle: The Tilt Aftereffect

“…In addition, there are scattered reports of periodic psychoses associated with certain phases of the human menstrual cycle [e.g. 21,26,50], and female psy chiatric patients tend to be admitted to hospital more frequently during these phases of the cycle [1,19,38], both of which phenomena may reflect disturbed dopa mine function. Fluctuations in the efficacy of neurolep tics over the cycle have been reported [48], and women appear to be more prone than men to develop parkinson ism, akathisia and tardive dyskinesias in response to neuroleptic drugs [23],…”

Measurements of small variations in ‘absolute’ pitch

“…The oestrogen level is known to have two peaks, one occurring in the premenstrual period and the other at ovulation (Dalton, 1959;Kopell, Lunde, Clayton & Moos, 1969). There are other hormonal changes which also have been observed to have two peaks in the menstrual cycle (Greene & Dalton, 1953;Dalton, 1959;Janowsky, Gorney & Mandell, 1967;Margerison, Anderson & Dawson, 1964;Bruce & Russell, 1962;Sargent & Weinman, 1966;Southam & Gonzaga, 1965).…”

“…There are other hormonal changes which also have been observed to have two peaks in the menstrual cycle (Greene & Dalton, 1953;Dalton, 1959;Janowsky, Gorney & Mandell, 1967;Margerison, Anderson & Dawson, 1964;Bruce & Russell, 1962;Sargent & Weinman, 1966;Southam & Gonzaga, 1965). Although it has not been possible to relate the changes definitely to any one hormone, it is still possible to see how a hormonal change could affect the pitch estimates because of their known general effect on the body.…”