Psychotic disorders can be exacerbated by the hormonal changes associated with childbirth, but the extent to which exacerbations occur with the menstrual cycle is unclear. We addressed this issue by conducting a systematic review. Embase, Medline, and PsychINFO databases were searched for studies that measured exacerbations of psychotic disorders in relation to the menstrual cycle. We extracted exacerbation measure, definition of menstrual cycle phase, and measurement of menstrual cycle phase. Standard incidence ratios were calculated for the perimenstrual phase based on the observed admissions during this phase divided by the expected number of admissions if the menstrual cycle had no effect. Random effects models were used to examine pooled rates of psychiatric admission in the perimenstrual phase. Nineteen studies, comprising 1193 participants were eligible for inclusion. Eleven studies examined psychiatric admission rates, 5 examined symptoms scores, 2 examined self-reported exacerbation, and 1 examined both admission rates and symptom scores. A random effects model demonstrated the rate of admissions during the perimenstrual phase was 1.48 times higher than expected (95% CI: 1.31-1.67), with no significant heterogeneity detected. Four of six symptom score studies reported perimenstrual worsening, but lack of consistency in timepoints precluded meta-analysis. Two studies examining self-reported menstrual exacerbations reported prevalences ranging from 20% to 32.4%. Psychiatric admission rates are significantly higher than expected during the perimenstrual phase. There is some evidence that a worsening of psychotic symptoms also occurs during this phase, but further research with more precise measurement of the menstrual cycle and symptomatology is required.

中文翻译：

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月经周期围经期的精神病恶化：系统评价和荟萃分析。

与分娩有关的激素变化可加剧精神病，但尚不清楚月经周期加剧的程度。我们通过进行系统的审查来解决此问题。在Embase，Medline和PsychINFO数据库中进行搜索，以研究与月经周期相关的精神病加重的研究。我们提取了加重量度，月经周期阶段的定义以及月经周期阶段的测量结果。如果月经周期没有影响，则根据月经期的入院率除以预期的入院次数，计算出月经期的标准发病率。随机效应模型用于检查月经期合并精神病患者的入院率。十九项研究，包括1193名参与者有资格被纳入。十一项研究检查了精神病学入院率，5项检查了症状评分，2项检查了自我报告的病情加重以及1项同时检查了入院率和症状评分。随机效应模型表明，经期入院率比预期高（1.45％，95％CI：1.31-1.67），未发现明显异质性。六项症状评分研究中有四项报告经期恶化，但由于时间点缺乏一致性，因此无法进行荟萃分析。两项检查自我报告的月经加剧的研究报告患病率从20％到32.4％。在月经期，精神病患者的入院率明显高于预期。有证据表明，在此阶段中还会出现精神病症状恶化的情况，