Psychosis may be linked to ovarian dysfunction conditions in adolescent females
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Key takeaways:
- There is limited literature on psychosis associated with ovarian pathologies in adolescent females.
- Psychosis related to ovarian etiology can be either hormonal or neoplastic in origin.
NEW YORK — Gynecological conditions with hormonal derangements may contribute to secondary psychosis among adolescent females, according to results of a literature review presented at the American Psychiatric Association Annual Meeting.
Low estrogen levels have been found in patients with psychosis and are also associated with potentially coexisting contributory gynecologic pathologies but, due to limited literature on this subject, researchers sought to compile available data to highlight the management complexities of these conditions.
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“This literature review has a list of ovarian dysfunction conditions that could contribute to psychosis,” Vatsala Sharma, MD, a resident at Mount Sinai/Elmhurst Hospital Center, told Healio. “It’s advised to the clinicians to look into the underlying ovarian dysfunctions and the possibility of underlying female endocrine derangements before committing to psychiatric interventions.”
To explore the correlation between gynecologic conditions with hormonal derangements and psychosis in adolescent females, Sharma and colleagues conducted a narrative 10-year literature review based on data from original studies, systemic reviews, meta-analyses, literature reviews, case series and case reports selected from Google Scholar and PubMed.
The included studies explored the role of hormones in psychosis and neurological symptoms in adolescent females, ovarian pathologies contributing to psychosis, psychosis associated with hormonal dysregulation, and antipsychotics and hormonal derangement.
Based on their review, the researchers found that causes of ovarian dysfunction/hormonal derangement can include polycystic ovary syndrome and benign or malignant ovarian tumors. Thus, when psychosis is related to ovarian etiology, the researchers noted it can be either hormonal or neoplastic in origin.
Specifically, hypoestrogenism associated with gynecological pathologies such as PCOS can contribute to psychosis, whereas ovarian tumors can produce neuropsychiatric manifestations due to paraneoplastic encephalitis.
Results of the review also showed that catamenial psychosis and menstrual exacerbation of underlying schizophrenia can occur due to estrogenic derangement and require differentiation in adolescents for adequate management.
Also, researchers noted that the impact of antipsychotics-associated hormonal dysregulation can contribute to hyperprolactinemia, vitamin D deficiency and osteoporosis in adolescent females.
“Further studies should explore the epidemiology, genetic predisposition, preventive approaches and management alternatives of neuropsychiatric symptoms secondary to ovarian dysfunction leading to hormonal dysregulation in adolescent females,” they wrote.