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。精神病的复发对病人的生活具有不可思议的破坏性。对于患有精神病的女性来说，月经期前后复发的风险特别高。患者群体报告说，月经周期是一个需要考虑的重要话题，但迄今为止，它在研究中相对被忽视了。月经周期会影响女性精神病患者的原因尚不清楚，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中很重要。这对那些最近患上精神病的人和那些精神病风险较高的人来说都是如此。对压力的反应在月经周期中也有所不同，这可以解释为什么精神病似乎在月经期间恶化。我们将使用新开发的智能手机应用程序Social Mind来测量日常压力反应。智能手机应用程序为参与者提供了一种方便的方式来测量月经周期和对压力的反应。它们也可以用来监测社交退缩，通过减少运动来衡量。该应用程序将使用手机移动数据来被动测量社交退缩。参与者将使用这款应用来记录她们的月经。有精神病风险或正经历首次精神病发作的妇女将被要求完成这些测量。为了比较，健康的妇女也将完成这些措施。我们将分析社会压力和退缩是否受到月经周期的影响。我们将检查是否精神病复发更可能在周期的某些时间，如果压力影响它。我们将比较患有精神病的妇女、有患精神病风险的妇女和未受精神健康问题影响的妇女之间的差异。人们希望通过了解月经如何影响精神病患者对压力的反应，从而确定新的治疗目标。目前，所有的抗精神病药物都以类似的方式起作用，并且有令人烦恼的副作用。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.