menstrual cycle psychosis
Introduction
Introduction to menstrual periodic psychosis Experts have noticed that many women have poor mood and anxiety during the two weeks before menstruation, called "premenstrual tension syndrome" or menstrual periodic psychosis. However, there are some women who are more serious, have mental disorders, and even have delusional hallucinations. However, once menstruation comes, the condition will be cured and will be repeated next month. The characteristics of menstrual periodic psychosis are: sudden onset 2 weeks before menstruation (ovulation or luteal phase), rapid relief in menstrual cramps or menstruation. basic knowledge The proportion of illness: 0.002% Susceptible people: women Mode of infection: non-infectious Complications: Infertility, headache, dizziness, epilepsy
Cause
Causes of menstrual periodic psychosis
Cause (75%):
I used to think that the problem lies in the deficiency of sex hormones. By supplementing progesterone, the ratio of lutein to estrogen in the body can be adjusted to cure the disease. Through years of practice, it can be seen that the problem is not at the level of sex hormones, but at the higher level. The brain center.
Prevention
Menstrual periodic psychosis prevention
Prevention of recurrence: Endocrine preparations are the drug of choice for the treatment of this disease. Commonly used endocrine preparations are:
1 testosterone, generally intramuscular injection of testosterone propionate 25mg, 1 or 2 times a week, 12 to 24 times for a course of treatment.
2 progesterone, intramuscular injection 10 days before menstruation, each time 10mg, once a day, menstrual discontinuation, if necessary, can be increased to 20mg.
3 contraceptives, commonly used compound norethisterone and compound methyl progesterone tablets, taking the menstrual cramps on the 3rd to 5th day, 1 tablet per night, and even serving 22 days for a course of treatment, after the next menstrual cramps For two courses, severe patients can take 2 to 3 tablets a day.
4 thyroxine, mild patients can take 60mg per night, severe can be 3 times a day, each time 60mg, 5 oryzanol, 20 ~ 30mg each time, 3 times a day, can be used as adjuvant therapy.
Lithium carbonate is better for controlling emotional symptoms and can prevent recurrence. The general dose is 750~2250mg/day, divided into three oral doses.
Complication
Menstrual periodic psychotic complications Complications infertility headache vertigo epilepsy
Can be complicated by female infertility, headache, dizziness, epilepsy and epileptic seizures.
Symptom
Symptoms of menstrual periodic psychosis Common symptoms Premenstrual syndrome menstrual period advance consciousness disorder hallucination emotional ups and downs
The characteristics of menstrual periodic psychosis are:
1 sudden onset 2 weeks before menstruation (ovulation or luteal phase).
2 Rapid relief in menstrual cramps or menstruation.
3 The condition is not limited to mood swings, and may have psychotic symptoms, especially hallucinations, apparently uncoordinated exercise excitement, a few are exercise inhibition, behavioral disorders with mild disturbance of consciousness, illusions of fragments, delusions and language disorders; Emotions are high or low.
4 In the period of remission, with sufficient self-knowledge, urgent treatment and prevention of recurrence, but naturally to the next cycle.
5 antipsychotic drugs or electroconvulsive therapy have no obvious effect, while sex hormone drugs have a certain effect.
Examine
Menstrual periodic mental illness examination
Neurological examination, exclusion of organic lesions, and examination of sex hormone levels are helpful in diagnosis. The nervous system examination is to determine the location and extent of damage and damage to the nervous system, that is, to resolve the "positioning" diagnosis of the lesion. The examination should be carried out in a certain order and with the general physical examination. The cranial nerves are usually first examined, including their movements, sensations, reflexes, and autonomic functions, and then the motor and reflexes of the upper and lower limbs are examined in turn, and the sensory and autonomic nervous systems are finally examined.
Diagnosis
Diagnosis and diagnosis of menstrual periodic psychosis
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Rapid-circulating affective disorders, rickets, and schizophrenic psychosis should be excluded.
(1) rickets and mental disorders, also known as separation disorders.
1 Emotional outbreak: The patient suddenly appears in the clinical symptoms characterized by venting after being stimulated by the spirit. He is crying, screaming and noisy, telling people the grievances and unhappiness in an extremely exaggerated attitude, and even licking his feet. The head hits the wall or rolls on the ground, but the disturbance of consciousness is not obvious. The duration of the attack is related to the surrounding environment. Emotional outbreak is the most common mental disorder in patients with rickets.
2 disturbance of consciousness: manifested as a state of consciousness or lethargy, the patient suddenly fainted, refrained from refusing, unable to push; sputum sputum state, excitement, emotional richness or hallucination, illusion: rickets, patient manifestation The family wandered around and wandered around: rickets dreaming, getting up in bed, going out or doing some movements and then falling asleep: rickets, pseudo-dementia, naive expression, answering questions, or the answer is not correct.
3 rickets mental illness: patients with emotional excitement, speech disorder, short-lived illusion, delusion, blind running or wounding and destruction, generally lasted 3 to 5 days.
4 : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : "Things are related to superstition, religious or cultural backwardness."
(2) Diagnostic criteria for schizophrenic psychosis:
Meets the diagnostic criteria for schizophrenia, but meets the symptom criteria for less than one month.
