Circannual and menstrual rhythm characteristics in manic episodes and body temperature.

Most reports in the literature deal with groups when summarizing the timing of affective disorders along the scale of the year and the menstrual cycle. In order to look for any regularity in timing of manic episodes in a single individual along these two time scales, a woman with a history of mania only, caused by schizoaffective disorder and on maintenance therapy with thioridazine hydrochloride self-measured basal body temperature daily and recorded onset and duration of manic episodes for 11 years. Statistically significant rhythms were found in body temperature with periods equal to the menstrual cycle and the year, with acrophase (highest values) during the luteal phase and winter, respectively. The timing of 11 manic episodes was not random but occurred during distinct portions of the menstrual cycle and the year. Most manic days occurred near menstruation or during the follicular phase of the menstrual cycle (up to ovulation) and between December and May (winter-spring). A temporal schedule for psychopharmacological treatment designed from individualized, longitudinal records that adjusts daily dosages according to both time of year and stage of menstrual cycle might alleviate or minimize the occurrence, magnitude and/or duration of mania and possibly other affective disorders that are found to be associated with underlying biological periodicities.

Case study of psychophysiological diary: infradian rhythms.

A 4-year case study was made of a 42-year-old white woman as seen through the psychophysiological diary. There was an awakening diary and a bedtime diary composed of 125 variables. The data are divided into two series: series I containing a manic episode, and series II as a control. Spectral analysis shows infradian rhythms in hypoglycemia and fear (11 days) and time to fall asleep (5 days). Depressed feelings showed a circatrigintan (28-day) rhythm, which was not correlated with menses. Mania had an annual rhythm (spring) but no circatrigintan or less rhythm. The following correlations have a P value less than or equal to 0.01: mania was directly correlated with number of sleeping pills, time to really wake up, need for rest, moodiness, and helplessness, and indirectly with expectations, pressure at work, sense of time, and emotional state. Interestingly, awakening pulse is directly correlated with awakening temperature, number of sleeping pills, bedtime pulse, tiredness at bedtime, hypoglycemia, and fear. Bedtime pulse is directly correlated with awakening pulse and awakening temperature. Both pulse and temperature at bedtime are directly correlated with negative variables such as tiredness, moodiness, helplessness, and depression, and inversely correlated with positive variables such as happiness, loving, performance at work, and thinking efficiency. This study demonstrates a significant correlation between physiological variables.