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.
"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 . "
[Show abstract][Hide abstract] ABSTRACT: It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicide.
The Scientific World Journal 02/2013; 2013(6):485851. DOI:10.1155/2013/485851 · 1.73 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: PURPOSE: To review evidence-based clinical practice guidelines, which link a cross-disciplinary knowledge base to the screening, assessment, self-care, and medical management of perimenstrual symptoms and discomforts, premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and premenstrual magnification (PMM). EPIDEMIOLOGY: Some 4% to 14% of women experience recurring perimenstrual (before and during menstruation) symptoms that are distressing enough to be considered a chronic illness, and up to two thirds of women experience symptoms that are bothersome enough to seek professional advice. REVIEW SUMMARY: This article reviews the etiology, clinical presentation, assessment methods, and therapeutic strategies for perimenstrual symptoms, PMS, and PMDD. Evidence-based practice guidelines are summarized from 2 professional organizations representing women's health professionals: the American College of Obstetricians and Gynecologists (ACOG) and the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN). Both organizations recommend careful symptom pattern assessment and initiation of treatment with nonpharmacologic therapies. An evidence-based multimodal strategy - the Premenstrual Symptom Management Program (PMS-SMP) - also is described. TYPE OF AVAILABLE EVIDENCE: Randomized controlled trials, national treatment guidelines, unstructured reviews, case control series, prospective cohort studies. GRADE OF AVAILABLE EVIDENCE: Fair to good. CONCLUSION: The popular medical term premenstrual syndrome describes the cyclic recurrence of symptoms that impair a woman's health, relationships, and/or occupational functioning. Recently, an interdisciplinary group proposed a more precise classification - cyclic perimenstrual pain and discomforts (CPPD) - encompassing cyclic pelvic pain and mood and physical discomforts. PMDD, a severe form of PMS, also may be a separate condition and requires the presence of 5 or more symptoms, 1 of which must be irritability, depressed mood, anxiety, or affective lability. These diagnoses should be based on prospective documentation or symptoms over at least 2 menstrual cycles and carefully distinguished from the premenstrual magnification of somatic or mood disorders.
[Show abstract][Hide abstract] ABSTRACT: To investigate the available data regarding possible associations between phases of the menstrual cycle and suicidal behaviour.
A systematic search of major relevant databases was performed using appropriate search terms.
Forty-four relevant studies were identified in total, 13 pertaining to suicide, two pertaining to both attempted and completed suicide, 23 to suicide attempts, three to suicide attempts in those suffering from the premenstrual syndrome (PMS), three to suicidal ideation and two to repetitive self-harming behaviours. A variety of methodologies were used in these studies and there were notable differences in the conclusions reached. Studies with better methodology suggest that a positive relationship exists between aspects of the menstrual cycle and non-fatal suicidal behaviour. Such behaviour appears to be more common in those phases of the menstrual cycle when oestrogen levels are lowest (the late luteal and follicular phases), and in those suffering from PMS.
There appears to be an association between the menstrual cycle and non-fatal suicidal behaviours. Interaction between oestrogen and the serotonergic system may provide a possible mechanism.
Psychological Medicine 08/2006; 36(7):901-12. DOI:10.1017/S0033291706007392 · 5.94 Impact Factor
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