Metformine for psychosis associated with the menstrual cycle in a patient with polycystic ovary syndrome.

Arch Womens Ment Health. 2008 Dec;11(5-6):387-8. Epub  2008 Oct 1.


1st Psychiatric Department, Aristotle University of Thessaloniki, Thessaloniki, Greece,


There are several reports of periodic psychotic disorders that appear in connection with the various phases of the menstrual cycle. Although the pathogenesis of menstrual psychosis has not been systematically investigated, it appears that it might be linked to an estrogen cascade that follows a period of sustained high estrogen levels, as in the case in anovulatory cycles. We present a case of psychosis associated with the menstrual cycle in a patient with polycystic ovary syndrome, a disorder typically characterized by anovulatory cycles, in whom the restoration of normal menstruation with use of metformine led to significant improvement of psychotic symptoms.



Screening for bipolar disorder in women with polycystic ovary syndrome: a pilot study.

Affect Disord. 2006 Apr;91(2-3):205-9. Epub  2006 Feb 17.

Screening for bipolar disorder in women with polycystic ovary syndrome: a pilot study.


Department of Psychiatry, Mount Sinai Medical Center, 1 Gustave L. Levy Place, Box #1230, New York, NY 10029-6574, USA.

Erratum in

  • J Affect Disord. 2007 Jan;97(1-3):277.



Previous reports have attributed polycystic ovary syndrome (PCOS) to valproate treatment in women with bipolar disorder and with epilepsy. However, since high rates of mood disorders have been identified in women with PCOS, we sought to investigate the hypothesis that an intrinsic association may exist between PCOS and bipolar disorder, independent of pharmacotherapy.


Seventy-eight women identified with PCOS were screened for the presence of bipolar illness using the Mood Disorders Questionnaire (MDQ), a validated self-assessment screen for bipolar disorder.


Twenty-eight percent of subjects had either a previous bipolar diagnosis or met MDQ threshold criteria for bipolar screen positivity. Ninety seven percent of previously diagnosed or MDQ screen-positive subjects had no valproate exposure before PCOS diagnosis.


Possible selection bias, lack of direct comparison with a control group, and lack of knowledge of specific diagnostic work up for PCOS, should all be considered in interpretation of these results. The MDQ as a self-report screen may be less sensitive to detect bipolar II or NOS than bipolar I disorder, and was not corroborated by a diagnostic interview.


These preliminary findings suggest a higher rate of bipolar screen positivity among women with PCOS than is expected in the general population, independent of an association with valproate. This observed link between PCOS and bipolar screen-positivity is consistent with a possible shared hypothalamic-pituitary-gonadal axis abnormality.

Prevalence of psychiatric disorders in patients with polycystic ovary syndrome.

Compr Psychiatry. 2010 Nov-Dec;51(6):599-602. Epub  2010 Mar 29.

Prevalence of psychiatric disorders in patients with polycystic ovary syndrome.


Panic and Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, INCT Translational Medicine (CNPq), Rio de Janeiro 79020-011, Brazil.



To investigate the prevalence of psychiatric disorders among women in ambulatory treatment for polycystic ovary syndrome (PCOS) and to correlate its clinical and demographic aspects with mental disorders.


Seventy-two patients in ambulatory treatment at the Endocrinal and Gynaecological Institute of the Federal University of Rio de Janeiro were evaluated using Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition criteria by means of MINI (Mini International Neuropsychiatric Interview, version 4.4). Polycystic ovary syndrome was confirmed according to the ultrasonographic criteria of Adams and by clinical parameters.


Forty-one patients (57%) presented at least one psychiatric diagnosis. Among them, the prevalence of mood disorder reached 78%. The most prevalent diagnostics were major depression (26.4%) and bipolar disorder (11.1%).


A high prevalence of mental disorders was observed, especially major depression and bipolar disorder. The data obtained regarding the relationship between PCOS and mood disorders in a Brazilian sample is in accordance with recent research findings in the same area.

Copyright © 2010 Elsevier Inc. All rights reserved.

[PubMed – indexed for MEDLINE]

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