Fifty patients who attended a medical or gynæcological outdoor department with the diagnosis of "menopausal syndrome" were examined psychiatrically with interviews, social histories and, in all but 5 cases, Rorschach tests.In 23 cases the emotional disturbances were the chief spontaneous complaint so that a psychiatrist had been called in as consultant. The remaining 27 cases would not have been seen by a psychiatrist, had it not been for this study."Menopausal depression" is a uniform clinical picture ; it is a reactive depression which presents only an accentuation of a previously existing maladjustment. It is clearly distinguishable from other so-called involutional disorders. The "causes" of this depression in the group examined are most frequently crude and obvious. They are almost exclusively associated with marriage and reproduction.The patient's premorbid personality differs essentially from that described by previous authors as characteristic of involutional psychoses.There is no correlation between the intensity of hot flushes on one hand and the severity of the emotional disturbance on the other. There does not appear to be any correlation between estrogenic deficiency and the severity of the emotional disturbance. Among complaints, pelvic pain is most intimately associated with the more severe forms of maladjustment.Considerably more of the cases of artificial menopause were found among the severely maladjusted women. In the majority of these cases, however, the injurious life situation preceded the artificial menopause. A qualitative descriptive study of these cases suggests that the patients reacted to psychological traumas with uterine dysfunction.From this it appears that the "menopausal" character of these depressive reactions is due to an additional conversion mechanism. An attempt is being made to explain this mechanism on the basis of our case studies.Abstract Teaser