Bipolar Disorder and Perimenopause: An Update

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders Pub Date : 2026-09-30 DOI:10.1111/bdi.70186

Jana Radosavljevic, Deniz Bengi, Benicio N. Frey

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引用次数: 0

Abstract

Objectives

Perimenopause has been associated with mood worsening in some individuals, including increased depressive symptoms. Yet, the link between bipolar disorder (BD) and perimenopause remains understudied. This review aimed to provide an update on recent original studies and contextualize findings within the broader literature to guide future research and clinical practice.

Methods

A systematic search was conducted on Embase (January 1, 2018 to August 5, 2026) to identify studies on BD (I, II, or NOS/BD spectrum) that directly or indirectly examined perimenopause and BD. Pooled samples were included if they reported separate BD results. Results were narratively synthesized.

Results

Fourteen studies were identified from Australia (n = 4), Italy (n = 3), UK (n = 2), Taiwan (n = 1), South Korea (n = 1), Sweden (n = 1), USA (n = 1), and one study of international trials. There is converging evidence showing that perimenopause is a period of higher risk of first onset BD. Among individuals with existing BD, increased depression and heightened anxiety during perimenopause were the most consistent illness-course findings, whereas findings for hypo/mania were mixed. Evidence concerning psychotherapy or pharmacological treatment, including hormone replacement therapy, was limited or absent.

Conclusions

This review provides an updated perspective on BD and perimenopause, extending existing knowledge beyond mood symptoms and identifying several clinical and research gaps. Clinicians should consider the potential impact of perimenopause in BD management. Research using standardized menopause staging criteria (e.g., STRAW+10) is encouraged to inform mechanisms, illness trajectories, treatments, and to better support individuals with BD through perimenopause.

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双相情感障碍和围绝经期：最新进展。

目的：围绝经期与某些个体的情绪恶化有关，包括抑郁症状增加。然而，双相情感障碍（BD）与围绝经期之间的联系仍未得到充分研究。本综述旨在提供最新的原始研究，并在更广泛的文献中提供背景研究结果，以指导未来的研究和临床实践。方法：在Embase上进行系统检索（2018年1月1日至2026年8月5日），以确定直接或间接检测围绝经期和BD的BD （I、II或NOS/BD谱）研究。如果合并样本报告单独的BD结果，则纳入。对结果进行叙述性综合。结果：14项研究来自澳大利亚（n = 4）、意大利（n = 3）、英国（n = 2）、台湾（n = 1）、韩国（n = 1）、瑞典（n = 1）、美国（n = 1）和1项国际试验研究。越来越多的证据表明，围绝经期是首次发病双相障碍的高风险时期。在已有双相障碍的个体中，围绝经期抑郁和焦虑的增加是最一致的病程发现，而躁狂/躁狂的发现则是混合的。有关心理治疗或药物治疗，包括激素替代疗法的证据有限或缺失。结论：本综述提供了双相障碍和围绝经期的最新观点，扩展了现有知识，超越了情绪症状，并确定了一些临床和研究空白。临床医生应考虑围绝经期对BD管理的潜在影响。鼓励使用标准化的绝经分期标准（例如STRAW+10）进行研究，以了解机制、疾病轨迹、治疗方法，并更好地支持双相障碍患者度过绝经期。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bipolar Disorders 医学-精神病学

CiteScore

8.20

自引率

7.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.