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.
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