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The authors consider this an introductory attempt to correlate menstrual disturbances with mental illness in 100 cases, among which were thirty-four cases of manic-depressive psychosis and thirty-five cases of schizophrenia, the remainder being diagnosed as psychoneuroses and 'miscellaneous cases'. They note that in hypomania 'the flow is regular, but tends to be more profuse and of longer duration than usual'. In mania irregularities and occasionally amenorrhea appear. In mild depression no changes are noted; in severe depression, 'there may be at first an increase in the amount and duration of the flow, then it is late and of short duration Finally … amenorrhea is found'. In general amenorrhea there is 'an expression of intensely painful emotional states regardless of the type of personality disorder'.
Ignorance of the function of menstruation in advance of its first appearance usually leads the girl to feel inferior and to make 'the compensatory strivings so often observed as a masculine protest'. The authors stress the sense of guilt aroused by the first menstruation, also the feeling on the part of the girl that she has been punished or injured.
The reaction to the menopause is the reaction to a loss or deprivation and very often consists of a 'sadistic compensatory attitude' towards menstruation itself.
In attempting to correlate menstrual disorders with other factors such as diet, weight, appetite and so on, the authors found the most direct correlation was with intense emotional reaction, of whatever type. They believe that both the menstrual disorders and the emotionality are manifestations of total change in the individual and refrain from indicating any causal relationship between them.