Investigating the Effect of the Menstrual Cycle on Social Stress in Early Psychosis Through Ecological Momentary Assessment

精神病是一种严重的精神疾病，对社会和受影响的个人都有重大代价。精神病的复发对患者的生活造成了令人难以置信的破坏。对于患有精神病的女性来说，月经前后的时间具有特别高的复发风险。患者团体报告说，月经周期是一个重要的考虑话题，但到目前为止，它在研究中相对被忽视了。月经周期影响精神病女性的原因尚不清楚，但可能与社会压力有关。对压力的反应，特别是在社交场合，似乎在精神病的发展过程中很重要。对于最近患上精神病的人以及那些精神病风险较高的人来说，情况就是如此。对压力的反应在月经周期中也不同，这可以解释为什么精神病似乎在月经前后恶化。我们将使用一款新开发的智能手机应用Social Mind来衡量日常对压力的反应。智能手机应用程序为参与者提供了一种方便的方法来测量月经周期和对压力的反应。它们还可以用来监测社交退缩，通过减少活动来衡量。这款应用程序将使用手机移动数据来被动地衡量社交退缩。参与者将使用这款应用来记录他们的月经周期。有精神病风险或正在经历第一次精神病发作的女性将被要求完成这些措施。作为对比，健康女性也将完成这些措施。我们将分析社交压力和退缩是否会受到月经周期的影响。我们将研究是否在周期的特定时间段精神病复发的可能性更大，以及压力是否会影响精神病复发。我们将比较患有精神病的女性、有精神病风险的女性和未受精神健康问题影响的女性之间的差异。希望通过了解月经如何影响精神病患者对压力的反应，将确定新的治疗目标。目前，所有的抗精神病药物都有相似的作用方式，而且都有麻烦的副作用。稳定荷尔蒙波动的药物代表了一种完全不同的方法，可能对一些女性有效。

Psychosis is a severe mental illness which has major costs both to society and to individuals affected. Relapses of psychosis are incredibly disruptive for patients' lives. For women who have psychosis, the time around their menstrual period carries a particularly high risk for relapse. Patient groups report that the menstrual cycle is an important topic for consideration but it has been relatively overlooked in research to date. The reasons why the menstrual cycle should affect women with psychosis are not clear but may relate to social stress. Response to stress, particularly in social situations, seems to be important in the development of psychosis. This is the case for people who have recently developed a psychotic illness as well as those who are at higher risk of psychosis. Response to stress also varies across the menstrual cycle, which could explain why psychosis seems to worsen around the time of menstruation. We will use a newly developed smartphone app, Social Mind to measure daily responses to stress. Smartphone apps offer a convenient way for participants to measure both the menstrual cycle and response to stress. They can also be used to monitor social withdrawal, measured through reduced movement. The app will use phone movement data to passively measure social withdrawal. The app will be used by participants to record their menstrual periods. Women who are either at risk of psychosis or who are experiencing their first episode of psychosis will be asked to complete these measures. For comparison, healthy women will complete the measures as well.We will analyse whether social stress and withdrawal are affected by the menstrual cycle. We will examine whether relapse of psychosis is more likely at certain times of the cycle and if stress influences it. We will compare differences between women who are experiencing psychosis, those at risk of psychosis and those not affected by mental health problems.It is hoped by understanding how the menstrual affects response to stress in psychosis, new targets for treatment will be identified. At present, all antipsychotic medications work in a similar way and have troublesome side-effects. Medications that stabilise hormonal fluctuations represent a completely different approach that could work for some women.