Psychiatric aspects of the menopause

Article Abstract:

The effects of menopause, the time of life when women lose their reproductive capability, has historically been associated with vague and even erroneous notions regarding mental health. It is frequently assumed that menopause carries with it a high risk for psychiatric disorders. This assumption is linked with the general view that behavioral disturbance and reproductive function in women are related. This bias is illustrated in the word 'hysteria', which comes from the Greek word for uterus. While much gynecological and psychoanalytic literature asserts such a view, the psychiatric literature provides no concrete evidence that the physiological changes associated with menopause have any direct bearing upon mental status. The available literature from gynecological, general population studies, and psychiatry are compared and reviewed in an attempt to define a relationship between menopause and mental illness. Although the hormonal changes of menopause do produce profound physical effects, including effects on sex drive and performance, any relationship between menopause and mental illness is more likely to be due to cultural, social, or familial factors. For example, a woman's changing sense of identity and role may have a greater impact upon her mental health than menopause itself. It is also pointed out that while the standard treatment for menopausal symptoms, estrogen replacement therapy, may be useful for hot flashes, or may alleviate painful intercourse, it has no real effect upon any associated psychological disorder. A relationship between menopause and psychiatric illness is not supported by any evidence and probably persists as a result of cultural attitudes, mass media, and the promotion of estrogen sales. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Complications and side effects, Physiological aspects, Menopause

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Genetic linkage in mental illness: limitations and prospects

Article Abstract:

Although results of studies of genetic factors in mental illness have not been consistent or easy to interpret, recent advances in molecular biology have renewed hope for the discovery of disease-related genes. Now, the most commonly used research approach is linkage analysis. Linkage refers to the tendency of alleles (genetic variations) to be inherited together. Two alleles placed close together on a chromosome are more likely to be inherited together than are two alleles which are set further apart. This knowledge allows genetic variations to serve as linked markers for other genes, once their existence and location have been ''tagged.'' If linkage between a disease and a marker locus becomes well established, then the linkage will come to define a specific genetic disorder that will be mapped to a well understood region of the human chromosome. This information can potentially be used to predict disease susceptibility. Methodological problems and analytical questions central to the design and interpretation of linkage studies in mental disorders are discussed. Problematic areas in studying complex psychiatric disorders include diagnostic uncertainties, difficulties in assessing the true mode of inheritance in a given family, cohort effects (such as changes in rates of mental illness over time, or across generations), and difficulties in assessing advantages and drawbacks of different types of linkage analyses and related statistical approaches. Familiarization with the potential pitfalls in linkage analysis is recommended, in order to avoid inconsistent and irreproducible study findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Methods, Genetic research, Linkage (Genetics)

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Schizophrenia and affective disorders: are they genetically linked?

Article Abstract:

There is considerable debate over whether or not schizophrenia and depression are distinct disorders. Some say they are not, and that they simply represent different points on a continuum. Schizoaffective disorder, which has symptoms of schizophrenia and affective disorder, adds fuel to the debate. The present investigation was designed to shed light on two questions. The first asks if the families of schizophrenics, in which there are relatives with affective disorders, have higher rates of schizophrenia and related disorders. The second asks if there is a higher or lower rate of affective disorder in families of schizophrenics, if the family has a high incidence of schizophrenia. Clinical interviews were conducted and medical records were reviewed for 90 chronic schizophrenics and their families. First the rates of schizophrenia and related disorders in the relatives of schizophrenics with and without a family history of affective disorder were compared. The difference was significant only when the spectrum of schizophrenic disorders was considered, but not for schizophrenia alone. The rate of affective disorder was then determined for family members of patients with and without a family history of schizophrenia. Families of schizophrenics with a family history of schizophrenia were prone to affective disorder, but the results did not achieve statistical significance. Support was found for a connection between schizophrenia and affective disorder, but these relationships were weak. (Consumer Summary produced by Reliance Medical Information, Inc.)

Genetic aspects, Family, Affective disorders, Mood disorders, Schizophrenics, editorial

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