Psychiatric, Cognitive Functioning and Socio-cultural Views of Menstrual Psychosis in Oman: An Idiographic Approach

Abstract

Background : Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only a few. Objective : To determine whether the cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnosis criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington’s sub-types (World Psychiatry. 2005;4(1):9-17). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and narrated idioms of distress . Results : The spectrum of distress in people with menstrual psychosis does not fit into existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomenon related to manic and psychotic symptoms or, in the parlance of Omani society, spirit possession. In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including dimensions of processing speed, episodic memory, and executive functioning. Within the given society, the periodicity of mind alteration has been attributed to spirit possession. Conclusions : This is one of the first case series of its kind in the country elucidating whether the manifestation of menstrual psychosis among individuals in Oman fulfills the subtypes postulated by Brockington. The present case series suggests that menstrual psychosis is marked with neuropsychological impairments that were previously observed in other phasic manic episodes or brief psychotic disorders.