Reproductive cycle-associated mood symptoms in women with major depression and bipolar disorder

Johns Hopkins University, Baltimore, Maryland, United States
Journal of Affective Disorders (Impact Factor: 3.71). 05/2007; 99(1-3):221-9. DOI: 10.1016/j.jad.2006.08.013
Source: PubMed

ABSTRACT We sought to determine the prevalence of, and association between, reproductive cycle-associated mood symptoms in women with affective disorders. We hypothesized that symptoms would correlate with each other across a woman's reproductive life span in both major depression (MDD) and bipolar I disorder (BP).
2412 women with, MDD or BP were asked standardized questions about mood symptoms prior to menstruation, within a month of childbirth and during perimenopause. Lifetime rates for each of these symptom types were determined and an odds ratio was calculated correlating each of the types with the others.
Of 2524 women with mood disorders, 67.7% reported premenstrual symptoms. Of those at risk, 20.9% reported postpartum symptoms and 26.4% reported perimenopausal symptoms. The rates did not differ between women with MDD and BP but were significantly different from women who were never ill. The symptoms were significantly correlated in women with MDD with odds ratios from 1.66 to 1.82, but were not in women with BP.
This is a secondary analysis of a sample that was collected for other purposes and is based upon retrospective reporting.
Reproductive cycle-associated mood symptoms were commonly reported in women with mood disorders and did not differ based on diagnosis. In MDD, but not BP, the occurrence of these symptoms was trait-like as the presence of one predicted the occurrence of the others. Further prospective study is required to clarify the determinants of this trait.

  • Source
    • "Future analysis with a restricted female control group assessed in regard to the menstrual cycle will be necessary for forming definitive conclusions . Fourth, it was reported that treated women with BPD do not seem to have menstruation-related mood symptoms (Payne et al., 2007; Shivakumar et al., 2008; Sit et al., 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: We examined a rapid-cycling bipolar disorder patient who demonstrated manic episode regularly at around day 7 of the menstrual cycle. We hypothesize that gonadal hormones may induce a state-dependent change in cerebral microstructure and function. Following this hypothesis, the serum levels of estradiol and progesterone were analyzed and diffusion tensor imaging data were examined between the manic and euthymic states of the patient. Estradiol levels increased in the late follicular phase at manic state when compared to the luteal or early follicular phase at euthymic state. DTI results showed that the patient had increased fractional anisotropy values at manic state in the bilateral nucleus accumbens (NAc) and its connected areas, which is a major projection field of the mesolimbic dopamine (DA) system, perhaps reflecting microstructural changes due to neuronal activation related to manic episodes. According to these results, we consider that the mesolimbic DA system of this patient has hypersensitivity to estradiol, and elevation of the estradiol level increases the activity of the dopaminergic system, which in turn may contribute to recurrent manic episodes. Our findings provide a clue for understanding how fluctuations in gonadal hormone may amplify or ameliorate the symptomatology of psychiatric disorders related to the menstrual cycle.
    12/2013; DOI:10.1016/j.pscychresns.2013.11.006
  • Source
    • "Biological differences between men and women in terms of neuroanatomy, neurochemistry, and reactivity to hormones have been unequivocally established (Cosgrove, Mazure, & Staley, 2007), highlighting a hormonal milieu in women that is quite distinct from men. In addition, women are unique in that they experience rapid hormonal shifts secondary to reproductive life stages such as menstruation, childbirth, and perimenopause which again may predispose them to mood symptoms at such times (Payne, Palmer, & Joffe, 2009; Payne et al., 2007). Biology is not the only explanatory factor for the disproportionate number of women experiencing depression, however , and women are much more likely than men to be subject to significant psychosocial stressors that may increase the risk of developing depression (Gulcur, 2000; Millaire, Bujold, Morency, & Gauthier, 2006; Stewart, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract From menarche to menopause, women are highly vulnerable to major depression. While biological and psychosocial differences between men and women have been established, the reason for the preponderance of depression in women has yet to be fully elucidated. Women may be predisposed to depressive illness because of biological factors related to brain structure, function, and the impact of reproductive life stages. They may also be at increased risk because they are differentially disadvantaged with respect to environmental stressors including interpersonal violence, socioeconomic instability, and caregiving burden, among others. However, not all women develop depression, nor do all individuals who suffer from adverse life events. This narrative review focuses on emerging research related to the interaction between sex, genetics, and environmental factors that may help offer clues about why some individuals suffer from depression, and why others may be resilient to this outcome. While many questions remain unanswered, the psychodynamic psychotherapist can use this information to help patients suffering from depression understand some of the complexities of the determinants of risk and resilience, with the goal of moving forward toward recovery.
    12/2013; 41(4):541-551. DOI:10.1521/pdps.2013.41.4.541
  • Source
    • "It has been hypothesised that these women have a heightened sensitivity to hormonal changes and are therefore more prone than others to experience psychological symptoms or psychological disorders during different reproductive phases (Halbreich 2010; Payne et al. 2007; Soares 2010; Soares and Zitek 2008). Numerous clinical and a few population-based studies support this " reproductive hormone sensitivity " hypothesis (Soares and Zitek 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The reproductive life of women is characterised by a number of distinct reproductive events and phases (e.g. premenstrual phase, peripartum, perimenopause). The hormonal transitions during these phases are often associated with both psychological and physical symptoms. Associations between these reproductive phases have been shown by numerous studies. However, the relationship between symptoms during the premenstrual phase and during early pregnancy has received little attention thus far, although early pregnancy is a time of dramatic hormonal as well as physical adaptation. Findings are based on a prospective longitudinal study with N = 306 pregnant women (MARI study). Three hundred five women that had menstrual bleeding in the year before pregnancy rated the severity of psychological and physical symptoms during premenstrual phases in the year preceding pregnancy. Besides this, they rated the severity of the same symptoms during early pregnancy (weeks 10 to 12 of gestation). The overall severity of premenstrual symptoms was significantly associated with the overall severity of early pregnancy symptoms (b = 0.4, 95 % CI = 0.3-0.5; p < 0.001). The overall severity of early pregnancy symptoms was best predicted by the severity of premenstrual irritability. The best predictor for a particular symptom in early pregnancy mostly was the corresponding premenstrual symptom. The associations between premenstrual and early pregnancy symptoms support the reproductive hormone sensitivity hypothesis that some women are prone to repeatedly experience specific psychological and physical symptoms during different reproductive phases. The findings further imply that the nature of symptoms might be rather consistent between different reproductive phases.
    Archives of Women s Mental Health 01/2013; 16(2). DOI:10.1007/s00737-012-0322-y · 1.96 Impact Factor
Show more