Psychotic women can estimate menstrual cycle phase as well as controls

SCHIZOPHRENIA RESEARCH ELSEVIER

Schizophrenia Research 23 (1997) 185-186

Letter to the Editor

Psychotic women can estimate menstrual cycle phase as well as controls Katherine Thompson **a*b,Anthony de Castellab, Jayashri Kulkarni b a Swinburne University of Technology, Hawthorn, Victoria 3122, Australia b Monash University, Department of Psychological Medicine, Dandenong Hospital, 134 Cleeland St., Dandenong, Victoria 3175, Australia

Accepted 3 September 1996

Dear Editor, There has been a distinct under-representation of women in studies, particularly those which have been concerned with schizophrenia (Kaplan et al., 1990; Wahl and Hunter, 1992). Reasons for omitting women from studies generally revolve around issues related to the menstrual cycle and the numerous changes which are associated therewith. Recently these very changes, in particular fluctua-

tions in estrogen across the menstrual cycle, have been hypothesised to be responsible for the superior functioning of women with schizophrenia as compared to men (Seeman and Lang, 1990; Riecher-Rossler and Hafner, 1993). This highlights the importance of including women in such research. We have undertaken a study which addresses some of these issues related to women and the

Table 1 Number of correct estimations of menstrual phase Blood phase

Questionnaire phase Folhcular

Follicular Luteal

18 (78%) 15 (88%) 1 (13%) 1 (20%)

Luteal 2 2 6 4

(9%) (12%) (75%) (80%)

Ovulatory 1 (33%) Total

35

15

Ovulatory

Unknown

Total

3 (13%)

23 17 8 5 1 3

3

57

1 (13%) 1 ( 100%) 2 (67%) 4

n = 57. P, psychotic; C, control; blood phase, biological menstrual phase; questionnaire phase, subjectively estimated menstrual phase. Presented at: The Australian Society for Psychiatric Research, Melbourne, Australia, December 1995. *Corresponding author. Tel.: +61 3 98770470; Fax: 161 3 9792 2152. 0920-9964/97/$17.00 Copyright 0 1997 Elsevier Science B.V. All rights reserved SO920-9964(96)00101-6

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menstrual cycle. It aimed to establish if women with psychosis were as accurate at estimating their menstrual cycle phase, as compared to normal women. A total of 32 psychotic and 26 normal women participated in the study. They did not differ significantly in age. Seven women had a diagnosis of schizophrenia, five affective disorder, two schizoaffective, and 18 remained undiagnosed but had psychosis, as measured by the SAPS and BPRS. The patient group was medicated, but neither subject group were taking oral contraceptives at the time of testing. Each subject was administered a menstrual cycle questionnaire, and had a blood sample taken, in order to establish both subjectively and objectively what each subject’s menstrual phase was. The principle finding of this study was that there was no significant difference in the psychotic women’s ability to estimate their menstrual phase, compared to the normal women (F= 1.70, p = 0.198). A summary of results is shown in Table 1. The psychotic women were slightly less reliable at estimating their menstrual phase. This small

Research

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difference can be attributed to the greater number of menstrual abnormalities that were also reported by this group. The main implication of these results is in regard to the inclusion of women as subjects in research. This study refutes the commonly held belief that psychotic women have little awareness of menstrual phase, since no significant difference was found between the psychotic women or the normal women in their ability to estimate their menstrual phase. In fact both groups were extremely accurate.

References Kaplan, B.J. Whit&t, S.F. and Robinson, J.W. (1990) Menstrual cycle phase is a potential confound in psychophysiology research. Psychophysiology, 27(4), 445-450. Riecher-Rossler, A. and Hafner, H. (1993) Schizophrenia and estrogens: is there an association? Eur. Arch. Psychiatry Clin. Neurosci. 242, 323-328. Seeman, M.V. and Lang, M. (1990) The role of estrogens in schizophrenia gender differences. Schizophr. Bull. 16(2), 185-194. Wahl, O.F. and Hunter, J. (1992) Are gender effects being neglected in schizophrenia research? Schizophr. Bull. 18(2), 313-317.