Publications by authors named "Emorfia Gavrilidis"

Pre-menstrual disorders, including pre-menstrual syndrome and pre-menstrual dysphoric disorder, are highly prevalent disorders in women of reproductive age. Pre-menstrual disorders are associated with debilitating symptoms that onset in the days prior to menses. A complex interplay between hormonal fluctuations, cellular sensitivity, and psychosocial stressors likely underly the pathophysiology of pre-menstrual disorders.

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Early life trauma is a risk factor for many mental disorders; however, there is a lack of research exploring early life trauma in Premenstrual Dysphoric Disorder (PMDD), a debilitating form of Premenstrual Syndrome (PMS). This descriptive study aimed to determine the prevalence of early life trauma in women with PMDD and characterise type and age of trauma experience. Data for 100 women diagnosed with PMDD was extracted from the Monash Alfred Women's Mental Health Clinic Database.

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Despite many studies implicating reproductive hormones in the development and outcome of schizophrenia, few have characterised the association between symptomatology and hormonal trajectories. To understand the influence of hormones on schizophrenia symptoms, serum steroids (estradiol, progesterone, follicular stimulating hormone (FSH), luteinising hormone (LH), and dehydroepiandrosterone (DHEA)) and psychopathology (The positive-and-negative-syndrome-scale(PANSS)) and depression (Montgomery-Asberg-Depression-Rating Scale(MADRS)) were collected across 12-weeks in 45 women (mean age 46) diagnosed with schizophrenia. To account for potential heterogeneity, Group-based-trajectory-modelling of psychopathology was used to identify distinct subgroups of individuals following a similar pattern of association between symptom score and hormone levels over-time.

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Background: Ondansetron is a serotonin 3 receptor antagonist widely used to prevent nausea and vomiting in pregnancy and in patients receiving chemotherapy. There is growing evidence that adjunctive ondansetron treatment improves symptomatology associated with schizophrenia, particularly with respect to the positive, negative and cognitive symptoms. Further studies that are applicable to real world practice are required to assess the efficacy and effectiveness of this treatment, which could be readily and rapidly translated into clinical practice.

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The menopause transition is a time when women experience an increased risk for new onset depression, as well as relapse of depression. While there are overlapping symptoms between major depression and depression during menopause, differences suggest 'perimenopausal depression' may be a unique subtype of depression associated with characteristic symptoms. There is currently no validated scale designed to measure perimenopausal depression.

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Background: Many women with no past psychiatric history experience severe mood symptoms for the first time in their life during the menopausal transition, with debilitating long-term consequences. Women with a history of depression can experience a relapse or worsening of symptoms during the menopause transition. Traditional antidepressants, SSRIs or SNRIs, are commonly prescribed as the first line response.

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Background: Borderline personality disorder (BPD) is a complex, severe and highly stigmatised psychiatric illness. Several lines of evidence highlight the causal link between chronic stress, glucocorticoid response to stress and glutamatergic overactivity as a key event in the pathophysiology of BPD. Therefore, molecular mechanisms capable of regulating glutamate excitotoxicity represent novel and potentially promising treatment targets.

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Background: A history of trauma is linked to the development of a wide range of mental health problems, and has long-lasting physiological and psychological consequences. The importance of clinicians directly questioning trauma history has been consistently emphasised in the literature.

Aims: To investigate whether a trauma history is obtained from female psychiatry inpatients during an inpatient admission.

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Importance: A substantial proportion of women with schizophrenia experience debilitating treatment-refractory symptoms. The efficacy of estrogen in modulating brain function in schizophrenia has to be balanced against excess exposure of peripheral tissue. Raloxifene hydrochloride is a selective estrogen receptor modulator (mixed estrogen agonist/antagonist) with potential psychoprotective effects and fewer estrogenic adverse effects.

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Objective: Oestradiol has been implicated in the pathogenesis of schizophrenia. Women with schizophrenia often suffer with menstrual dysfunction, usually associated with low oestradiol levels, but whether menstrual dysfunction has an effect on their psychiatric symptoms is not well researched. The aim of this study is to document the menstrual characteristics of women with chronic schizophrenia with focus upon menstrual regularity, menstrual cycle length and menstrual symptoms.

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Background: Many women diagnosed with varying psychiatric disorders take antipsychotic medications during pregnancy. The safety of antipsychotic medications in pregnancy is largely unknown.

Methods: We established the National Register of Antipsychotic Medications in Pregnancy in 2005.

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Emerging research has suggested that hormone treatments such as selective oestrogen receptor modulators (SERMs) or progestins may be useful in the treatment of mania. The current pilot study compared the use of the SERM tamoxifen and the progestin medroxyprogesterone acetate (MPA), as an adjunct to mood stabiliser medications, for the treatment of mania symptoms in 51 women in a 28-day double blind, placebo controlled study. The primary outcome was the change between baseline and day 28 mania scores as measured by the Clinician Administered Rating Scale for Mania (CARS-M).

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The theory that many serious mental illnesses, in particular psychoses such as schizophrenia, may have a significant hormonal aetiological component is fast gaining popularity and the support of scientific evidence. Oestrogen in particular has been substantially investigated as a potential mediator of brain function in schizophrenia. Epidemiological and life-cycle data point to significant differences in the incidence and course of schizophrenia between men and women suggests a protective role of oestrogen.

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In recent years the perimenopause has become recognised as a 'window of vulnerability' for women's mood. The risk of depression during perimenopause is high and treatment failure is common. Perimenopausal depression encompasses both new onset (first episode) depression occurring during perimenopause as well as a relapse during perimenopause in women with a history of depression.

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