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October 1967

The Menstrual CyclePsychiatric and Ovarian-Adrenocortical Hormone Correlates: Case Study and Literature Review

Arch Gen Psychiatry. 1967;17(4):459-469. doi:10.1001/archpsyc.1967.01730280075009

IN WOMEN the ovulatory, premenstrual, and menstrual periods are associated with increased psychiatric and somatic disturbances. Estimates of incidence have varied from 25% to 100% of women, depending on the definitions used. In unpublished data, we found that up to 90% of women claim to undergo premenstrual or menstrual hopelessness, depression, or irritability.

The literature shows increased incidences of medical and surgical admission, episodes of alcoholism, depressive reactions, schizophrenic reactions, acute psychiatric hospitalizations, suicide attempts, and suicides occurring in the premenstrual-menstrual phases of the monthly cycle.1-4 Cases of recurrent premenstrual-menstrual psychotic, neurotic, and acting-out behavior have been described.5-8

The etiology of the cyclic upsets is poorly understood. Psychoanalytic explanations stress activation of conflicts concerning factors such as sexuality, pregnancy, and castration.9-12 That the pathologic emotional findings are biochemically influenced is widely accepted. Speculations as to etiology are reviewed in Southam's article13 and include: sodium and

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