Detailed contribution information
| Contribution title | 3144 - Menstrual psychosis in a 12 year old girl |
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| Contribution code | PS01-43 (P) |
| Authors | |
| Form of presentation | Poster |
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| Abstract |
Periodic episodes of psychosis that occur in synchronicity with the menstrual cycle, also called menstrual psychoses, have been subject of clinical interest since the middle 19th century. Literature compraises mainly case reports of adolescents or women in the reproductive age, whereas only few case reports exist on children. Although their nosology and underlying pathogenesis are not yet completely understood, an association with bipolar disorders and puerperal psychosis is suggested. There is no consent on treatment so far. We report of a 12-year-old girl who presented four psychotic episodes, each starting 3-4 days before menstruation. She was first referred to our hospital during the third psychotic episode, which occurred 9 months after her menarche. The girl was flat in emotions and seemed to be anxious and disorganized. She showed delusions of reference, thought disorder and accelerated latency of mimic or verbal reactions, while her parents initially observed logorrhea, hypomanic mood and autonomic nervous symptoms such as flushing and sweating. The girl was described as usually high functioning and socially well integrated. The family refused any medication of the patient and after a few days the symptoms stopped spontaneously with complete recovery. Clinical examination, laboratory analyses with hormonal status and a toxicological screening had shown no pathological findings, as well as electroencephalography and brain MRI scans. During the next severe psychotic episode antipsychotic treatment with risperidone and subsequently aripiprazole was started. Medication has been tapered during the last 5 months without any relapse. A stabilizing medication with estrogen or progesterone is considered. Clinicians in charge of children and adolescents should be aware of menstrual psychosis as a rare but acute disorder in puberty. The differentiation of menstrual psychosis from premenstrual syndromes or severe schizophrenic and schizoaffective disorders is highly relevant due to different outcomes and therapeutic options. However, further systematic studies are needed to advance our pathogenetic understanding and thus treatment options of menstrual psychosis in child and adolescent psychiatry. |