Suicide attempts among women during low estradiol/low progesterone states.
The relationship between the menstrual cycle and risk for suicidal behaviors is not clear. The aim of this study is to determine whether perimenstrual phases in fertile women are associated with acute risk for suicide attempt and explore whether risk is elevated during low estradiol/low progesterone states. Women (N=431) recruited within 24h of a suicide attempt were assessed for psychopathology, suicidal behavior and LH, FSH, estradiol and progesterone blood levels. Among fertile women (N=281/431), suicide attempts were more likely to occur during menses (26%, 72/281 observed vs. 15%, 43/281 expected attempts; p<0.001). Compared to women whose attempts occurred during other phases, women who attempted suicide during low estradiol/low progesterone states (menstrual phase, amenorrhea and menopause) reported severe suicide intent, a measure that may be predictive of eventual suicide death. Suicide attempts among women are more likely when estrogen and progesterone levels are low and attempts made under these conditions are associated with greater severity. Low gonadal hormone levels may constitute a key factor in the neurobiological basis of suicidal behavior among women, suggesting a novel, testable hypothesis regarding the underpinnings of suicidal acts.
Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, NY, USA.
Enrique
E
Baca-Garcia
Carmen
C
Diaz-Sastre
Antonio
A
Ceverino
M Mercedes
MM
Perez-Rodriguez
Rocio
R
Navarro-Jimenez
Jorge
J
Lopez-Castroman
Jeronimo
J
Saiz-Ruiz
Jose
J
de Leon
Maria A
MA
Oquendo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects / Q000502:physiology; D008599:Menstruation Disturbances / Q000097:blood* / Q000188:drug therapy / Q000523:psychology*; D008875:Middle Aged; D011374:Progesterone / Q000097:blood*; D011619:Psychotropic Drugs / Q000494:pharmacology / Q000627:therapeutic use; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
D011619:Psychotropic Drugs; D011374:Progesterone; D004958:Estradiol