The impact of sexual hormones on depressive symptoms and alcohol use in a woman with delusional disorder at the perimenopausal stage: case report and review of recent works

Abstract

IntroductionThe influence of sexual hormones on mental disorders have been extensively reported. In fact, recent studies suggest that sex hormones may play a relevant role in the pathophysiology of psychosis, may be a precipitant when exogenously administered or even be used as a treatment agent of psychotic disorders.ObjectivesTo describe the case of a patient with a recent diagnosis of delusional disorder (DD) with an onset in the perimenopausal period.MethodsCase report and narrative review focused on the impact of sexual hormones on depressive symptoms and alcohol use comorbidity during perimenopause in DD women by using PubMed database.ResultsCase report: A 48-year-old woman diagnosed with DD. The clinical assessment of climacteric symptoms, as well as the gonadotropins (elevated levels of follicle-stimulating hormone -FSH- and luteinizing hormone -LH-) and estrogen levels monitoring (variations on 17-β-estradiol -E2-) enabled to link the endocrine changes with the onset and course of the psychiatric disorder. During the development of the disease, the patient also presented comorbid depressive symptoms and alcohol use disorder. Review: Estrogen depletion seems to increase the risk of psychosis, while scientific literature is not conclusive in establishing a definitive relationship between depressive symptoms and hormonal imbalance in DD. Alcohol use disorder is a common comorbidity in both perimenopausal women and patients with DD.ConclusionsMultiaxial management of the case helped clinicians to achieve clinical stabilization. Sex differences as well as hormonal pattern disturbances should receive special attention due to the seminal implications in pharmacotherapy and clinical outcomes.DisclosureNo significant relationships.