REPRODUCTIVE ENDOCRINE FUNCTION AND MOOD IN WOMEN WITH BIPOLAR DISORDER

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。我们将检验以下假设：1.与年龄和体重指数(BMI)匹配的对照组相比，患有双相情感障碍(BPD)的女性月经异常的频率更高。2.BPD患者无排卵、高雄激素血症/高雄激素血症和胰岛素抵抗(IR)的发生率较高，与治疗药物无关。3.在诊断为BPD之前有超重/肥胖史、月经异常和/或多毛症的妇女患多囊卵巢综合征(PCOS)的风险比没有这些病史和对照组的BPD妇女更高。该项目将扩大BPD妇女目前的生殖生物学知识，并评估情绪稳定剂和非典型抗精神病药物(AAPS)的影响。它的目的是通过以下方式扩大BPD妇女目前的生殖生物学知识：1)确定BPD妇女与健康对照组相比的生殖功能障碍的频率；2)确定生殖功能障碍的预测因素；3)制定指南，最大限度地减少对接受BPD治疗的妇女生殖健康的潜在不利影响。实验设计：拟议的5年研究将比较150名接受BPD治疗的女性，年龄18-40岁，以及30名年龄和体重指数匹配的健康对照组。生殖功能的评估将在连续三个月经周期期间通过问卷调查和激素评估进行。在筛查访问期间，研究临床医生将进行DSM-IV-患者版(SCID)的结构化临床访谈，并将进行问卷调查，评估受试者(如果有的话，还有他们的母亲亲属)的医疗、精神和生殖健康状况。这次访问还将包括体检，以评估多毛症、粉刺和体重指数。此外，将获得锂、丙戊酸(VPA)或其他抗惊厥药物水平的血清水平(以检查服药依从性)，将完成尿毒学筛查(以确保戒酒和非法药物)，并将完成尿液HCG检测以排除怀孕。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We will test the following hypotheses: 1. Women with bipolar disorder (BPD) will have a higher frequency of menstrual abnormalities than age- and body mass index (BMI)-matched controls. 2. A higher frequency of anovulation, hyperandrogenism/hyperandrogenemia and insulin resistance (IR) occurs in women with BPD, regardless of the treating agent. 3. Women with history of overweight/obesity, menstrual abnormalities and/or hirsutism preceding the diagnosis of BPD will be at higher risk for development of polycystic ovarian syndrome (PCOS), than BPD women without such history and controls. This project will expand current knowledge of reproductive biology in women with BPD as well as assess the impact of mood stabilizers and atypical anti-psychotics (AAPs). It is designed to expand current knowledge of reproductive biology in women with BPD by: 1) determining the frequency of reproductive dysfunction in women with BPD compared to healthy controls; 2) identifying predictors for reproductive dysfunction; and 3) developing guidelines to minimize potential adverse effects on the reproductive health of women treated for BPD. Experimental Design: The proposed 5-yr study will compare 150 women treated for BPD, ages 18-40, and 30 age- and BMI-matched healthy controls. Assessments of reproductive function will be carried out by questionnaire and hormonal evaluation prospectively for the period of three consecutive menstrual cycles. During the screening visit, the Structured Clinical Interview for DSM-IV--Patient Edition (SCID) will be performed by the study clinician, and a questionnaire assessing the subjects' (and their maternal relatives', when available) medical, psychiatric and reproductive health will be administered. This visit will also include a physical examination to evaluate hirsutism, acne, and BMI. Additionally, sera levels will be obtained for lithium, valproic acid (VPA), or other anticonvulsant levels (to check medication compliance), a urine toxicology screening will be completed (to ensure abstinence from alcohol and illicit drugs), and a urine HCG test will be completed to rule-out pregnancy.