Premenstrual Mood Swings May Worsen Bipolar Disorder

FRIDAY, March 18 (HealthDay News) -- Women with bipolar disorder who experience premenstrual exacerbation of their symptoms are more likely to have a worse course of illness, a shorter time to relapse, and more severe symptoms, according to a study published online Feb. 15 in The American Journal of Psychiatry.

Rodrigo S. Dias, M.D., of the Massachusetts General Hospital in Boston, and colleagues investigated the course of illness and time to relapse of bipolar disorder in women who experienced premenstrual exacerbation of their mood symptoms. As part of the Systematic Treatment Enhancement Program for Bipolar Disorder, they followed 293 women for one year, comparing the frequency of mood episodes in women with and without premenstrual worsening of symptoms, and time to relapse among the subgroup of 129 women who were in a recovered status at baseline.

The researchers found that the women with premenstrual exacerbation of bipolar disorder had more episodes, primarily depressive, than the group without. Women with premenstrual exacerbation had more depressive and mood-elevation symptoms overall, relapsed more rapidly, and had more severe symptoms. They did not, however, meet criteria for rapid cycling; but, on retrospective reporting, they were more likely to be rapid cyclers.

"Our findings suggest that reports of premenstrual exacerbation may be a potential marker for a more severe clinical phenotype in reproductive-age women with bipolar disorder," the authors write.

Several authors disclosed financial relationships with the pharmaceutical industry.

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