Bipolar disorder in women with premenstrual exacerbation.

摘要

In this issue, Dias and collaborators (1) prospectively examine the course of bipolar illness in 191 women with self-identified premenstrual exacerbation and 102 women without it, finding a worse course of illness with a more rapid rate of relapse and more syndromal and subsyndromal episodes in the women with premenstrual exacerbation. Despite the increase in the number of episodes, women with self-identified premenstrual exacerbation were not more likely to qualify for a diagnosis of rapid cycling. The authors suggest that women with a sensitivity to times of hormonal change may suffer more mood instability in general. The authors conclude that self-reporting of premenstrual exacerbation may be a clinical marker predicting a more symptomatic and relapse-prone type of bipolar disorder in reproductive-age women.