Perimenopause-Related Mood and Behavioral Disorders

• INCLUSION CRITERIA:

• Perimenopausal Subjects:

  • History within the last one year of at least one month with perimenopause-related mood or behavioral disturbances of at least moderate severity - that is, disturbances that are distinct in appearance and associated with a notable degree of functional impairment;
  • Age 40-65;
  • History of the onset of menstrual irregularity during the past six months but not greater than one year of amenorrhea (i.e., not postmenopausal);
  • Biological evidence of a deterioration of normal ovarian activity, specifically, plasma FSH levels persistently elevated (> 14IU/L) (as recommended by the Stages of Reproductive Aging Workshop criteria (106)) drawn at two week intervals over a period of eight weeks;
  • No prior estrogen replacement therapy for treatment of perimenopausal physical or emotional symptoms within the last six months; and
  • In good medical health;
  • Subjects must be competent to comprehend the purpose of the screening process and to provide written informed consent and be willing to participate in NIMH IRB approved research protocols.
• A control group of age-matched perimenopausal women who meet patient selection criteria with the exception of the presence of mood or behavioral disorders will also be sought.

• Premenopausal women will be women who meet the following inclusion criteria for the longitudinal study participants:

  • Regular menstrual cycle function (21-34 days);
  • Absence of current mood or behavioral disturbance as determined by a structured diagnostic interview;
  • Plasma gonadotropin levels in pre-perimenopausal range (<14 IU/L);
  • In good medical health; and
  • Medication free.

EXCLUSION CRITERIA:

• Primary general medical illness (i.e., appears to be causing the mood disorder);
• Current antidepressant therapy (since this is a screening protocol for subsequent treatment studies in which participants must be untreated). Antidepressants will not be withheld from participants who need or want them;
• Current alcohol or substance abuse or dependence (excluding nicotine) of sufficient magnitude to require independent, concurrent treatment intervention (e.g., antabuse or opiate treatment, but not including self-help groups);
• Pregnant or lactating women;
• Subjects who are unable to provide informed consent.
• NIMH employees, staff and their immediate family members will be excluded from the study per NIMH policy.