Cyclic Psychosis Associated with the Menstrual Cycle

Abstract

Psychotic symptoms are not included under accepted definitions of premenstrual syndrome (PMS). We present a 14-year-old girl with PMS, who developed a late luteal cyclic psychosis during two consecutive premenstrual periods, which resolved completely after the onset of menses. She was treated with dehydroxyprogesterone for two cycles, and later with placebo for the next three consecutive cycles. Psychotic symptoms did not reappear following two psychotic cycles, and the PMS resolved within the next menstrual cycle. We suggest that cyclic psychoses associated with the menstrual cycle may be a specific benign entity, not included under the recognised functional psychoses. In some cases these psychoses could be classified as a subgroup of PMS.