Perimenopause-Related Mood and Behavioral Disorders

• INCLUSION CRITERIA:

• Perimenopausal Subjects:

• History within the last one year of at least one month withperimenopause-related mood or behavioral disturbances of at least moderateseverity - that is, disturbances that are distinct in appearance and associatedwith a notable degree of functional impairment;

• Age 40-65;

• History of the onset of menstrual irregularity during the past six months butnot greater than one year of amenorrhea (i.e., not postmenopausal);

• Biological evidence of a deterioration of normal ovarian activity,specifically, plasma FSH levels persistently elevated (> 14IU/L) (asrecommended by the Stages of Reproductive Aging Workshop criteria (106)) drawnat two week intervals over a period of eight weeks;

• No prior estrogen replacement therapy for treatment of perimenopausal physicalor emotional symptoms within the last six months; and

• In good medical health;

• Subjects must be competent to comprehend the purpose of the screening processand to provide written informed consent and be willing to participate in NIMHIRB approved research protocols.

• A control group of age-matched perimenopausal women who meet patient selectioncriteria with the exception of the presence of mood or behavioral disorders willalso be sought.

• Premenopausal women will be women who meet the following inclusion criteria for thelongitudinal study participants:

• Regular menstrual cycle function (21-34 days);

• Absence of current mood or behavioral disturbance as determined by a structureddiagnostic interview;

• Plasma gonadotropin levels in pre-perimenopausal range (<14 IU/L);

• In good medical health; and

• Medication free.

EXCLUSION CRITERIA:

• Primary general medical illness (i.e., appears to be causing the mood disorder);

• Current antidepressant therapy (since this is a screening protocol for subsequenttreatment studies in which participants must be untreated). Antidepressants will notbe withheld from participants who need or want them;

• Current alcohol or substance abuse or dependence (excluding nicotine) of sufficientmagnitude to require independent, concurrent treatment intervention (e.g., antabuseor opiate treatment, but not including self-help groups);

• Pregnant or lactating women;

• Subjects who are unable to provide informed consent.

• NIMH employees, staff and their immediate family members will be excluded from thestudy per NIMH policy.