REPRODUCTIVE ENDOCRINE FUNCTION AND MOOD IN WOMEN WITH BIPOLAR DISORDER

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。我们将测试以下假设：1。双相情感障碍（BPD）的女性比年龄和体重指数（BMI）匹配的对照组有更高的月经异常频率。2. BPD女性患者发生不排卵、高雄激素血症/高雄激素血症和胰岛素抵抗（IR）的频率较高，与治疗药物无关。3.在诊断BPD之前有超重/肥胖、月经异常和/或多毛症病史的女性比无此类病史的BPD女性和对照组发生多囊卵巢综合征（PCOS）的风险更高。 该项目将扩大目前对BPD妇女生殖生物学的了解，并评估情绪稳定剂和非典型抗精神病药物（AAP）的影响。它旨在通过以下方式扩展BPD女性生殖生物学的现有知识：1）确定与健康对照相比BPD女性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，以尽量减少对BPD治疗女性生殖健康的潜在不良影响。 实验设计：这项为期5年的研究将比较150名年龄在18-40岁之间接受BPD治疗的妇女和30名年龄和BMI匹配的健康对照。将通过问卷调查和激素评价对连续三个月经周期的生殖功能进行前瞻性评估。 在筛选访视期间，将由研究临床医生进行DSM-IV-患者版（SCID）的结构化临床访谈，并将进行评估受试者（及其母亲亲属，如可用）医学、精神和生殖健康的问卷调查。此次访视还将包括体格检查，以评估多毛症、痤疮和BMI。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（以检查药物依从性），将完成尿液毒理学筛选（以确保戒酒和禁用药物），并将完成尿液HCG检测以排除妊娠。

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.