Psychotic Attacks During Menstruation: A Case Report

Abstract

Menstrual psychosis is defined as a sudden onset psychotic episode that develops in the menstrual cycles, often once a month. In the psychotic period, symptoms such as confusion, non-speech, delusions and hallucinations are observed. It is discussed in the literature that psychosis occurring in the menstrual cycle develops due to increased dopamine sensitivity during low estrogen phases. In this study, a 13-year-old female adolescent case who showed affective and psychotic symptoms as of her first menstruation was discussed. Although cases of menstrual psychosis are seen very rarely, they are overlooked by being evaluated under the name of other psychotic disorders because they are not handled under a separate heading in a standard classification system in the clinical field. It is seen that the clinical findings of menstrual psychosis differ from diseases with other psychotic symptoms. Since case samples are limited in the clinical field, it is aimed to contribute to the researchers by revealing the diagnostic process and treatment course of a case in this study.

Keywords

• Adolescence
• Menstruation
• Psychosis

Menstrüasyon Sırasındaki Psikotik Ataklar: Olgu Sunumu

Abstract

Menstrüel psikoz, ani başlangıçlı, menstrual döngülerde sıklıkla ayda bir kez gelişen psikotik epizod olarak ifade edilmektedir. Olgularda psikotik dönemde konfüzyon, konuşmama, sanrılar ve varsanılar gibi bulgular görülmektedir. Adet döngüsü içinde ortaya çıkan psikozun düşük östrojen fazları esnasında artan dopamin duyarlılığından ötürü geliştiği alanyazında ele alınmaktadır. Bu çalışmada ilk adeti görmesi itibariyle affektif ve psikotik bulgular gösteren 13 yaşındaki kız ergen olgu ele alınmıştır. Menstrüel psikoz olguları çok nadiren görülmekle birlikte klinik alanda standart bir sınıflandırma sisteminde ayrı bir başlık altında ele alınmadığı için başka psikoz bozuklukları adı altında değerlendirilerek gözden kaçırılmaktadır. Menstrüel psikozun klinik bulgularının diğer psikotik belirtilerle giden hastalıklardan farklılaştığı görülmektedir. Klinik alanda vaka örnekleri sınırlı olduğu için bu çalışmada bir olgunun tanısal süreci ve tedavi seyrinin ortaya koyulması ile araştırmacılara katkı sağlaması amaçlanmıştır.

Keywords

• Ergenlik
• Menstrüasyon
• Psikoz

References

1. Abe, K., & Ohta, M. (1998). Recurrent brief episodes with psychotic features in adolescence: periodic psychosis of puberty revisited. Psychiatry and clinical neurosciences, 52(S6), S313-S316. https://doi.org/10.1111/j.1440-1819.1998.tb03255.x
2. Ahern, E., Cohen, D., Prior, C., & Raji, E. (2022). Menstrual psychosis. Irish Journal of Psychological Medicine, 39(1), 103-105. https://doi.org/10.1017/ipm.2019.36
3. Akdeniz, F., ve Karadağ F. (2006). Adet döngüsünün duygudurum bozuklukları üzerine etkisi var mıdır? Türk Psikiyatri Dergisi, 17, 296-304.
4. Aktepe, E., Ozen, E., & Eroglu, F. O. (2016). Menstrual psychosis: a case report/Menstrual psikoz: Olgu sunumu. Anadolu Psikiyatri Dergisi, 17(S3), 88-91.
5. Aktepe, E., ve Mutlu, G. (2022). Ergenlik döneminde farkındalığı az olan bir tanı: Menstruel psikoz. Psikiyatride Güncel Yaklaşımlar, 14(3), 308-315.
6. Alan, B. E., Akarçay, S., & Çelik, Y. S. (2022). Clarithromycin induced psychotic disorder with catatonic-like features in an adolescent girl: Case report. Turkish J Clinical Psychiatry, 25, 234-237.
7. Alptekin, K., Ulas, H., Akdede, B. B., Tümüklü, M., & Akvardar, Y. (2009). Prevalence and risk factors of psychotic symptoms: in the city of Izmir, Turkey. Social Psychiatry and Psychiatric Epidemiology, 44, 905-910.
8. Al-Sibani, N., Al-Maqbali, M., Mahadevan, S., Al-Huseini, S., Al-Muzeni, M., & Al-Adawi, S. (2020). Psychiatric, cognitive functioning and socio-cultural views of menstrual psychosis in Oman: an idiographic approach. BMC women's health, 20(1), 1-9. https://doi.org/10.1186/s12905-020-01060-z

9. Binbay, T., Ulaş, H., & Alptekin, K. (2007). Şizofrenide psikososyal etkenlerin yeniden önem kazanması. Psikiyatride Derlemeler, Olgular ve Varsayımlar, 1, 39-48.
10. Brockington, I. (1998). Menstrual psychosis. Archives of Women's Mental Health, 1, 3-13.
11. Brockington, I. F. (2011). Menstrual psychosis: a bipolar disorder with a link to the hypothalamus. Current psychiatry reports, 13(3), 193-197. https://doi.org/10.1007/s11920-011-0191-5
12. Caplan, R., Tanguay, P. E., & Szekely, A. G. (1987). Subacute sclerosing panencephalitis presenting as childhood psychosis. Journal of the American Academy of Child & Adolescent Psychiatry, 26(3), 440-443. https://doi.org/10.1097/00004583-198705000-00029
13. Che, K. I. (2016). Recurrent psychotic episodes with a nearmonthly cycle. East Asian Archives of Psychiatry, 26(4), 137-140.
14. Cole, P. M. (2016). Emotion and the development of psychopathology. Developmental psychopathology, 1-60.
15. Demjaha, A., Valmaggia, L., Stahl, D., Byrne, M., & McGuire, P. (2012). Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophrenia bulletin, 38(2), 351-359. https://doi.org/10.1093/schbul/sbq088
16. Ellison-Wright, Z., & O’Keane, V. (2013). Menstrual psychosis in an adolescent girl. Prog Neurol Psychiatry Case Notes, 17, 17-23.
17. Frank, R. T. (1931). The hormonal causes of premenstrual tension. Archives of neurology & psychiatry, 26(5), 1053-1057. https://doi.org/10.1001/archneurpsyc.1931.02230110151009
18. Fusar‐Poli, P. (2017). Why ultra high risk criteria for psychosis prediction do not work well outside clinical samples and what to do about it. World Psychiatry, 16(2), 212. https://doi.org/10.1002/wps.20405
19. Grünewald, B. D., Korte, A., & Schulte-Körne, G. (2012). Psychotic episodes during menstruation in a 12-year-old girl: a case of menstrual psychosis. European child & adolescent psychiatry, 21, 173-175. https://doi.org/10.1007/s00787-012-0242-4
20. Heinzman, J. T., & Buckingham, E. T. (2019). Menstrual psychosis and the workup of new-onset psychosis in a teenager. J Am Acad Child Adolesc Psychiatry Connect, 6(2), 36-39.
21. Hendrick, V., Altshuler, L. L., & Burt, V. K. (1996). Course of psychiatric disorders across the menstrual cycle. Harvard review of psychiatry, 4(4), 200-207. https://doi.org/10.3109/10673229609030544
22. Jarman, B., Hirsch, S., White, P., & Driscoll, R. (1992). Predicting psychiatric admission rates. British Medical Journal, 304(6835), 1146-1151. https://doi.org/10.1136/bmj.304.6835.1146
23. Karatepe, H. T., Işık, H., Sayar, K., & Yavuz, F. (2010). Menstruation-related recurrent psychotic disorder: a case report. Dusunen Adam The Journal of Psychiatry and Neurological Sciences, 23(4), 282.
24. Köroğlu, M. A., Bilici, M., & Bekaroğlu, M. (1999). Trabzon ili şizofreni prevalansı ve ilişkili sosyodemografik ve klinik özellikler. 35. Ulusal Psikiyatri Kongresi Bildiri Kitabı, Trabzon, 371-377.
25. Langer, S., Frankel, J., Derish, N., Poulsen, R., & Coffey, B. J. (2019). Brief psychosis in the premenstrual phase in an adolescent girl: adolescent menstrual psychosis? Journal of child and adolescent psychopharmacology, 29(5), 392-394. https://doi.org/10.1089/cap.2019.29168.bjc
26. Leibenluft, E., Fiero, P. L., & Rubinow, D. R. (1994). Effects of the menstrual cycle on dependent variables in mood disorder research. Archives of General Psychiatry, 51(10), 761-781. https://doi.org/10.1001/archpsyc.1994.03950100009002
27. Lewis, R. (1998). Typical and atypical antipsychotics in adolescent schizophrenia: efficacy, tolerability, and differential sensitivity to extrapyramidal symptoms. The Canadian Journal of Psychiatry, 43(6), 596-604. https://doi.org/10.1177/0706743798043006
28. McGrath, J. J. (2007). The surprisingly rich contours of schizophrenia epidemiology. Archives of General Psychiatry, 64(1), 14-16. https://doi.org/10.1001/archpsyc.64.1.14
29. Nomura, J., Hatotani, N., Yamaguchi, T., Inoue, K., Kitayama, I., & Higashimura, T. (1981). Periodic psychosis as a chronobiological disorder-endocrine studies and treatments. Biological psychiatry. Edited by Perris C, Struwe G, Jansson B. Amsterdam: Elsevier, 1235-1238.
30. Özpoyraz, N., Uğuz, Ş., ve Ertürk, D. (1996). Kısa psikotik bozukluk: Geriye dönük bir değerlendirme. Türk Psikiyatri Dergisi, 7, 116-122.
31. Paus, T., Keshavan, M., & Giedd, J. N. (2008). Why do many psychiatric disorders emerge during adolescence?. Nature reviews neuroscience, 9(12), 947-957. https://doi.org/10.1038/nrn2513
32. Phillips, L. J., McGorry, P. D., Yung, A. R., McGlashan, T. H., Cornblatt, B., & Klosterkötter, J. (2005). Prepsychotic phase of schizophrenia and related disorders: recent progress and future opportunities. The British Journal of Psychiatry, 187(S48), s33-s44. https://doi.org/10.1192/bjp.187.48.s33
33. Pringsheim, T., Doja, A., Belanger, S., & Patten, S. (2011). Treatment recommendations for extrapyramidal side effects associated with second-generation antipsychotic use in children and youth. Paediatrics & Child Health, 16(9), 590–598 https://doi.org/10.1093/pch/16.9.590
34. Riecher-Rössler, A., & Häfner, H. (1993). Schizophrenia and oestrogens—is there an association? European Archives of Psychiatry and Clinical Neuroscience, 242, 323-328. https://doi.org/10.1007/bf02190244
35. Saha, S., Chant, D., Welham, J., & McGrath, J. (2005). A systematic review of the prevalence of schizophrenia. PLoS medicine, 2(5), e141. https://doi.org/10.1371/journal.pmed.0020141
36. Sönmez, İ., ve Köşger, F., (2015). Şizofrenide menstrüel döngü: Bir olgu eşliğinde gözden geçirme. Arch Neuropsychiatr; 52:417-419.
37. Stein, D., Hanukoglu, A., Blank, S., & Elizur, A. (1993). Cyclic psychosis associated with the menstrual cycle. The British Journal of Psychiatry, 163(6), 824-828. https://doi.org/10.1192/bjp.163.6.824
38. Van Os, J. (2009). Schizophrenia/J. Os Van, S. Kapur. Lancet, 9690