Current Psychiatry Reports

, Volume 13, Issue 6, pp 500–503 | Cite as

The Relationship Between Bipolar Disorder, Seasonality, and Premenstrual Symptoms

  • Deborah R. Kim
  • Kathryn A. Czarkowski
  • C. Neill Epperson


Cyclical mood disorders characterized by shifting affective states include bipolar disorder, seasonal affective disorder, and premenstrual syndrome/premenstrual dysphoric disorder. In this article, we explore the relationship between these disorders and bring the reader up to date on the advances made in the past year in understanding the relationship between bipolar disorder, seasonality, and premenstrual symptoms.


Bipolar disorder Seasonality Seasonal affective disorder Women’s health Premenstrual syndrome Premenstrual dysphoric disorder Melatonin 


Papers of particular interest, published recently, have been highlighed as: • Of importance

  1. 1.
    Goikolea JM, Colom F, Martinez-Aran A, Sanchez-Moreno J, Giordano A, Bulbena A, et al. Clinical and prognostic implications of seasonal pattern in bipolar disorder: a 10-year follow-up of 302 patients. Psychol Med. 2007;37(11):1595–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Schaffer A, Levitt AJ, Boyle M. Influence of season and latitude in a community sample of subjects with bipolar disorder. Can J Psychiatry. 2003;48(4):277–80.PubMedGoogle Scholar
  3. 3.
    Shin K, Schaffer A, Levitt AJ, Boyle MH. Seasonality in a community sample of bipolar, unipolar and control subjects. J Affect Disord. 2005;86(1):19–25.PubMedCrossRefGoogle Scholar
  4. 4.
    Hakkarainen R, Johansson C, Kieseppa T, Partonen T, Koskenvuo M, Kaprio J, et al. Seasonal changes, sleep length and circadian preference among twins with bipolar disorder. BMC Psychiatry. 2003;3:6.PubMedCrossRefGoogle Scholar
  5. 5.
    Baek JH, Park DY, Choi J, Kim JS, Choi JS, Ha K, et al. Differences between bipolar I and bipolar II disorders in clinical features, comorbidity, and family history. J Affect Disord. 2011;131(1–3):59–67.PubMedCrossRefGoogle Scholar
  6. 6.
    • Choi J, Baek JH, Noh J, Kim JS, Choi JS, Ha K, et al. Association of seasonality and premenstrual symptoms in bipolar I and bipolar II disorders. J Affect Disord. 2011 Mar;129(1–3):313–6. This study investigated the association between BD I and BD II and PMS and seasonality. Seasonality and PMS is more commonly reported by BD II patients as compared with BD I patients. Google Scholar
  7. 7.
    Shand AJ, Scott NW, Anderson SM, Eagles JM. The seasonality of bipolar affective disorder: comparison with a primary care sample using the seasonal pattern assessment questionnaire. J Affect Disord. 2011;132(1–2):289–92.PubMedCrossRefGoogle Scholar
  8. 8.
    Simonsen H, Shand AJ, Scott NW, Eagles JM. Seasonal symptoms in bipolar and primary care patients. J Affect Disord. 2011;132(1–2):200–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Roecklein KA, Rohan KJ, Postolache TT. Is seasonal affective disorder a bipolar variant? Curr Psychiatry. 2010;9(2):42–54.Google Scholar
  10. 10.
    Mitchell PB, Wilhelm K, Parker G, Austin MP, Rutgers P, Malhi GS. The clinical features of bipolar depression: a comparison with matched major depressive disorder patients. J Clin Psychiatry. 2001;62(3):212–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Nau H, Kuhnz W, Loscher W. Effects of pregnancy on seizure threshold and the disposition and efficacy of antiepileptic drugs in the mouse. Life Sci. 1985;36(7):663–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Szuba MP, O'Reardon JP, Evans DL. Physiological effects of electroconvulsive therapy and transcranial magnetic stimulation in major depression. Depress Anxiety. 2000;12(3):170–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Payne JL, Klein SR, Zamoiski RB, Zandi PP, Bienvenu OJ, Mackinnon DF, et al. Premenstrual mood symptoms: study of familiality and personality correlates in mood disorder pedigrees. Arch Womens Ment Health. 2009;12(1):27–34.PubMedCrossRefGoogle Scholar
  14. 14.
    Wassermann EM. Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the international workshop on the safety of repetitive transcranial magnetic stimulation, June 5–7, 1996. Electroencephalogr Clin Neurophysiol. 1998;108(1):1–16.PubMedCrossRefGoogle Scholar
  15. 15.
    • Dias RS, Lafer B, Russo C, Del Debbio A, Nierenberg AA, Sachs GS, et al. Longitudinal follow-up of bipolar disorder in women with premenstrual exacerbation: findings from STEP-BD. Am J Psychiatry. 2011 Apr;168(4):386–94. This is the most recent article on premenstrual symptoms and BD. Results showed that women with BD and premenstrual symptoms have a worse course of illness and a shorter time to relapse. Google Scholar
  16. 16.
    Payne JL, Roy PS, Murphy-Eberenz K, Weismann MM, Swartz KL, McInnis MG, et al. Reproductive cycle-associated mood symptoms in women with major depression and bipolar disorder. J Affect Disord. 2007;99(1–3):221–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Lewy AJ, Wehr TA, Goodwin FK, Newsome DA, Rosenthal NE. Manic-depressive patients may be supersensitive to light. Lancet. 1981;1(8216):383–4.PubMedCrossRefGoogle Scholar
  18. 18.
    Nathan PJ, Burrows GD, Norman TR. Melatonin sensitivity to dim white light in affective disorders. Neuropsychopharmacology. 1999;21(3):408–13.PubMedCrossRefGoogle Scholar
  19. 19.
    Nurnberger Jr JI, Adkins S, Lahiri DK, Mayeda A, Hu K, Lewy A, et al. Melatonin suppression by light in euthymic bipolar and unipolar patients. Arch Gen Psychiatry. 2000;57(6):572–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Lewy AJ, Nurnberger Jr JI, Wehr TA, Pack D, Becker LE, Powell RL, et al. Supersensitivity to light: possible trait marker for manic-depressive illness. Am J Psychiatry. 1985;142(6):725–7.PubMedGoogle Scholar
  21. 21.
    Hallam KT, Olver JS, Horgan JE, McGrath C, Norman TR. Low doses of lithium carbonate reduce melatonin light sensitivity in healthy volunteers. Int J Neuropsychopharmacol. 2005;8(2):255–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Hallam KT, Olver JS, Norman TR. Effect of sodium valproate on nocturnal melatonin sensitivity to light in healthy volunteers. Neuropsychopharmacology. 2005;30(7):1400–4.PubMedGoogle Scholar
  23. 23.
    Parry BL, Meliska CJ, Sorenson DL, Lopez A, Martinez LF, Hauger RL, et al. Increased sensitivity to light-induced melatonin suppression in premenstrual dysphoric disorder. Chronobiol Int. 2010;27(7):1438–53.PubMedCrossRefGoogle Scholar
  24. 24.
    Garcia-Esteve L, Navarro P, Ascaso C, Torres A, Aguado J, Gelabert E, et al. Family caregiver role and premenstrual syndrome as associated factors for postnatal depression. Arch Womens Ment Health. 2008;11(3):193–200.PubMedCrossRefGoogle Scholar
  25. 25.
    Munk-Olsen T, Laursen TM, Mendelson T, Pedersen CB, Mors O, Mortensen PB. Risks and predictors of readmission for a mental disorder during the postpartum period. Arch Gen Psychiatry. 2009;66(2):189–95.PubMedCrossRefGoogle Scholar
  26. 26.
    Sharma V, Khan M. Identification of bipolar disorder in women with postpartum depression. Bipolar Disord. 2010;12(3):335–40.PubMedCrossRefGoogle Scholar
  27. 27.
    Heron J, Haque S, Oyebode F, Craddock N, Jones I. A longitudinal study of hypomania and depression symptoms in pregnancy and the postpartum period. Bipolar Disord. 2009;11(4):410–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Sharma V, Xie B. Screening for postpartum bipolar disorder: validation of the Mood Disorder Questionnaire. J Affect Disord. 2011;131(1–3):408–11.PubMedCrossRefGoogle Scholar
  29. 29.
    Spinelli MG. Postpartum psychosis: detection of risk and management. Am J Psychiatry. 2009;166(4):405–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Deborah R. Kim
    • 1
  • Kathryn A. Czarkowski
    • 1
  • C. Neill Epperson
    • 1
  1. 1.Department of Psychiatry, Penn Center for Women’s Behavioral WellnessUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations