Premenstrual symptoms marker of severe bipolar

WOMEN with bipolar disorder who have premenstrual depression and mood swings may be more prone to relapse, researchers say.

In the first large study to look prospectively at the impact of premenstrual exacerbation on bipolar illness, US researchers compared mood episodes over one year in 191 women with bipolar disorder who had premenstrual mood exacerbations, with 102 women with bipolar and no exacerbations.

They showed that 74% of women with premenstrual exacerbations had between one and three relapses per year, compared with 56% of women not reporting premenstrual exacerbations.

Women with premenstrual exacerbations were around half as likely to have no relapses, but there was no difference between the two groups for rapid cycling, defined as four or more episodes in a year.

The authors said it was possible that mood susceptibility to fluctuating hormone levels resulted in greater mood instability in general.

Women with