title: Premenstrual dysphoric disorder as a correlate of suicidal ideation, plans, and attempts among a nationally representative sample.
abstract: OBJECTIVE
  Suicide is a major public health concern and a leading cause of death in the United States. Psychopathology is an established risk factor for non-fatal suicidal behavior; however, it is unclear whether premenstrual dysphoric disorder (PMDD), a psychiatric disorder specific to women, is correlated with these outcomes. The objective of this study was to determine if PMDD status was associated with suicidal ideation, plans, and attempts, independent of socio-demographic factors and psychiatric comorbidity.
  
  
  METHODS
  We conducted a secondary data analysis of 3,965 American women aged 18-40 who participated in the Collaborative Psychiatric Epidemiology Survey. Descriptive statistics and forward stepwise logistic regression modeling were performed using SUDAAN software.
  
  
  RESULTS
  The prevalence of non-fatal suicidal behaviors increased in a graded fashion according to PMDD status. Although the control for demographic characteristics and psychiatric comorbidity greatly attenuated the unadjusted association between PMDD and suicidal behaviors, women with PMDD remained significantly more likely than women with no premenstrual symptoms to report suicidal ideation (OR 2.22; 95% CI 1.40-3.53), plans (OR 2.27; 95% CI 1.20-4.28), and attempts (OR 2.10; 95% CI 1.08-4.08). Only the likelihood of suicidal ideation was significantly elevated among women with moderate/severe premenstrual syndrome (PMS; OR 1.49; 95% CI 1.17-1.88), compared to women with no premenstrual symptoms.
  
  
  CONCLUSIONS
  PMDD was strongly and independently associated with non-fatal suicidal behaviors among a nationally representative sample. These findings suggest that clinicians treating women with PMDD should assess and be vigilant for signs of non-fatal suicidal behavior, and that clinicians should evaluate and treat the premenstrual symptoms of women who express these behaviors.
authors: Division of Biostatistics, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06510, USA. corey.pilver@yale.edu
authors: Corey E
authors: CE
authors: Pilver
authors: Daniel J
authors: DJ
authors: Libby
authors: Rani A
authors: RA
authors: Hoff
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D016017:Odds Ratio; D011293:Premenstrual Syndrome / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult