Premenstrual symptoms and luteal suicide attempts

Department of Psychiatry, Fundacion Jimenez Diaz, Madrid, Spain.
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.53). 10/2004; 254(5):326-9. DOI: 10.1007/s00406-004-0506-1
Source: PubMed


If premenstrual symptoms (PMS) are temporally and specifically associated with suicidal attempts, suicide attempts in women with PMS should occur more frequently in the luteal phase.
In a general hospital, 125 fertile female suicide attempters (and 83 blood donors as controls) with regular menstrual cycles were prospectively studied. A retrospective DSM-IV diagnosis of Premenstrual Dysphoric Disorder (PMDD) was made.
Attempts during the luteal phase were not more frequent in females with PMDD (34%,23/68) than in those without PMDD (35%, 20/57). The sample had enough power to detect medium and large effect sizes. As expected, there was a significantly higher frequency of PMDD in suicide attempters than in the controls (54% vs 6%; Fisher's exact test, p < or = 0.001).
This study was limited by the use of retrospective PMDD diagnosis but suggests that PMDD may not be associated with suicidal acts during the luteal phase,when PMS are present.

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    • "Non-fatal suicidal behavior and suicidal ideation seem to be more frequent when estrogen levels are lowest during the menstrual cycle, in particular the late luteal and follicular phases [56–58]. Besides, suicide attempters have shown higher prevalence of premenstrual symptoms and premenstrual dysphoric disorder than the general population [57]. "
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