Premenstrual Psychosis in A Patient with Polycystic Ovary Syndrome: A Case Report

Abstract

Periodic psychosis in relation to the menstrual cycle phases has been reported but its pathogenesis is not yet known. We report the case of a 28-year old female who had developed schizoaffective disorder over the preceding 10 years. She was diagnosed with polycystic ovary syndrome (PCOS) 3 years later and was noted to have distinct psychotic episodes that coincided acutely with her premenstrual period. Peculiarly she exhibited delusions of pregnancy during her psychotic episodes. This was followed by near resolution with the end of menstruation. This case sheds light on the atypical presentation of psychosis in female patients and the importance of eliciting psychotic symptoms in relation to the menstrual cycle. Considering the potential role of anovulatory cycles and oestrogen in perimenstrual psychoses, psychiatrists should also be aware of the use of antipsychotics that may exacerbate anovulation via hyperprolactinaemia.