Periodic Psychosis of Puberty: A Review on Near-Monthly Episodes

Abstract

Published cases of periodic psychosis of puberty and related papers were reviewed. The clinical picture is near-monthly recurrence of episodes of stupor or excitement lasting about 1 or 2 weeks, which are accompanied by delusion and in some cases also by hallucinations or confusion. This condition was found to occur more commonly in girls than in boys, and in half of the girls reported the episodes tended to start a few days before menses. Adolescents with mental retardation were more commonly affected, and this suggests that organic brain damage may play a role in the etiology in some cases. Short-term prognosis is usually favorable, but at long-term follow-up, nearly half of them were found to be suffering from affective or schizophrenic illness. The clinical importance of recognizing this psychosis early in the course of illness is emphasized.

Oestrogen withdrawal associated psychoses

“…Fourteen cases of psychoses were associated with menarche (48, 52, 57–64). Formerly defined as psychosis of puberty or adolescence (65), menarche‐associated‐psychoses first emerged just before the first menstruation of the adolescent, with the onset of the first psychotic episode immediately followed by the first menses. Compared with premenstrual psychoses, these menarche associated psychoses occurred earlier in the gynaecological life.…”

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“…Menstrual catatonia is a syndrome in which patients show psychotic symptoms associated with the menstrual cycle, is variously known as periodic psychosis of puberty or of adolescence (PPP/A) 9 or menstrual psychosis which includes patients in a wider age range. Menstrual psychosis rarely presents with catatonia.…”

Menstrual catatonia

“…THE SYNDROME IN which patients show psychotic symptoms associated with the menstrual cycle, is known as periodic psychosis of puberty 1 or of adolescence 2 (PPP/A) in the Japanese‐language literature. It remains unfamiliar, however, internationally.…”