Because of the usual temporal relationship between the menopause and the development of involutional psychoses, there has long been a tendency to link the two conditions in a causal relationship. The organic changes producing the clinical syndrome of the menopause have been thoroughly investigated, and it is now believed that the modus operandi is an exaggerated function of the pituitary resulting from ovarian failure, which can be demonstrated by an increased urinary excretion of gonadotropin. The clinical syndrome itself consists mainly in nervousness, headache, lassitude and depression, insomnia, irritability, hot flashes and various other vasomotor phenomena. Although one may be tempted to correlate some of these symptoms in their aggravated forms with the psychotic melancholia, it is by no means generally agreed that such a physiologic disturbance plays an etiologic role in the development of involutional psychoses.
Endocrine derangement in involutional melancholia should be demonstrable objectively in a manner similar