Perimenstrual psychosis among female adolescents: two case reports and an update of the literature.
OBJECTIVE
Perimenstrual psychosis is an uncommon disorder, not included under the accepted classifications of functional psychoses. Our aim was to describe two Israeli female adolescents who fit this diagnosis.


RESULTS
Both youngsters developed an acute psychosis a few days before menstruation, which subsided several days after bleeding, only to reappear in the same form in subsequent cycles. An extensive medical work-up did not show any significant disturbances, with the exception of anovulatory cycles in one youngster. Psychotropic treatment had no effect on the course of the psychosis. Treatment with a combined progesterone/estrogen contraceptive agent in one patient resulted in full recovery within several cycles. The second patient showed a spontaneous remission within four cycles. Follow-up for two to three years indicated a complete remission, with no need to reintroduce any psychotropic agent.


CONCLUSIONS
Perimenstrual psychosis may represent a cycloid disorder or an atypical affective disorder, associated with anovulation. The use of psychotropic treatment is considered inconclusive, whereas hormonal agents may prove effective.
Stein
Daniel
D
Tel Aviv University, Israel. dstein@netvision.net.il
Blumensohn
Rachel
R
Witztum
Eliezer
E
D000208:Acute Disease; D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use; D004338:Drug Combinations; D004361:Drug Tolerance; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011293:Premenstrual Syndrome / Q000188:drug therapy / Q000523:psychology*; D011374:Progesterone / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology*; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D004338:Drug Combinations; D004967:Estrogens; D011374:Progesterone