Understanding menstrual cycle effects on suicide will require prospective studies of suicidal thoughts and behaviors in premenstrual disorders

Owens, Siân-Eleri; Eisenlohr‐Moul, Tory A.

doi:10.1186/s12916-021-02010-8

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…Similarly, a study that surveyed 87 outpatient physicians found that only 11.5% routinely collected symptom ratings for 60 days to confirm the diagnosis of PMDD [ 16 ]. Part of the disconnect between the requirement of 60-day daily symptom charting for an accurate assessment of the diagnosis of PMDD and the clinical challenges implementing this recommendation in the real-world clinical practice is that the algorithms used to diagnose PMDD in research are not user-friendly for routine use in the clinical practice [ 43 ]. Therefore, because since the start of this project we envisioned the development of a user-friendly tool that could be widely implemented in the clinical practice, the MAC-PMSS attempts to bridge this gap between research and the clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Current efforts are underway to turn the paper and pencil version of the MAC-PMSS tool into an app, which will further improve access and acceptability of this new clinical tool. The development of automated systems for collection of daily ratings with standardized scoring and reporting of results to clinicians has been identified as a major step forward in this field [ 43 ]. However, despite its several years of clinical use as a diagnostic tool for PMDD in patients referred to a specialized mental health clinic, the MAC-PMSS has only been formally validated in individuals with BD and MDD.…”

Section: Discussionmentioning

confidence: 99%

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A DSM-5-based tool to monitor concurrent mood and premenstrual symptoms: the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS)

et al. 2022

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Background Despite high co-morbidity between premenstrual dysphoric disorder and mood disorders, there is a gap of research-based tools to monitor concurrent premenstrual and mood symptoms. In this study, we developed a new DSM-5-based questionnaire to prospectively monitor concurrent premenstrual and mood symptoms. Methods Fifty-two females with bipolar or major depressive disorder, ages 16–45, were enrolled in the study. Participants completed two months of prospective symptom charting including the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS) and the Daily Record of Severity of Problems (DRSP). At the end of the prospective charting, participants also completed the Montgomery-Åsberg Depression Rating Scale (MADRS), Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS). The MAC-PMSS was correlated with the DRSP, MADRS, HDRS and YMRS. Results All individual items of the MAC-PMSS correlated strongly with the individual DRSP scores (all p < 0.001). The mood section of the MAC-PMSS also significantly correlated with MADRS (r = 0.572; p < 0.01), HDRS (r = 0.555; p < 0.01) and YMRS scores (r = 0.456; p < 0.01). Conclusions The MAC-PMSS is a reliable to tool to measure concurrent mood and premenstrual symptoms in women with mood disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A DSM-5-based tool to monitor concurrent mood and premenstrual symptoms: the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS)

et al. 2022

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“…Original preregistered outcomes were based on less frequent lab-based interviews or self-reports; however, in the present paper, we chose to present the same outcomes as reported on the daily self-report survey , as recently recommended for alignment with best practice for the study of cyclical affective symptoms [ 44 ]. While the use of these more frequent daily assessments improves the granularity and interpretability of results, they do not result in substantive differences in the significance or direction of results (see NCT03720847 on ClinicalTrials.gov).…”

Section: Methodsmentioning

confidence: 99%

Effects of acute estradiol and progesterone on perimenstrual exacerbation of suicidal ideation and related symptoms: a crossover randomized controlled trial

et al. 2022

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Female suicide attempts peak peri-menstrually—around the onset of menses—when the ovarian steroids estradiol (E2) and progesterone (P4) fall rapidly. Given preclinical evidence that withdrawal from either E2 or P4 can provoke behaviors consistent with elevated suicide risk, we hypothesized that withdrawal from one or both of these steroids contributes to perimenstrual exacerbation of suicidal ideation (SI) and related symptoms. In a randomized, controlled, double-blind crossover experiment (NCT03720847), a transdiagnostic sample of naturally cycling, medically healthy psychiatric outpatients reporting past-month SI completed two conditions during two different 14-day experimental intervals (days 7–20 where the luteinizing hormone surge = day 0), separated by a monthlong washout cycle. In the E2 and P4 (EP) condition, participants received transdermal E2 (0.1 mg/day) plus oral micronized P4 (200 mg/day as 100 mg twice daily) to buffer perimenstrual steroid withdrawal. A matched placebo (PBO) condition allowed natural perimenstrual steroid withdrawal. Participants reported daily SI and planning (primary outcomes) and indices of depression (low mood, hopelessness), threat sensitivity (anxiety, perceived stress), executive functioning (difficulty concentrating, impulsivity), and social cognitive bias (rejection sensitivity, perceived burdensomeness). In baseline cycles, no participant met prospective criteria for DSM-5 premenstrual dysphoric disorder, but 59% met all criteria except full follicular symptom remission, and 93% showed the highest SI in the perimenstrual phase. Of 29 randomized, 28 were analyzed (14 EP-PBO, 14 PBO-EP). Experimental administration of E2 and P4 (relative to PBO) reduced perimenstrual exacerbation of SI, suicide planning, depression, hopelessness, perceived stress, rejection sensitivity, and perceived burdensomeness, particularly in the perimenstrual (natural E2 and P4 withdrawal) days. Further, delayed withdrawal from experimental E2 and P4 (but not PBO) recapitulated SI, hopelessness, and rejection sensitivity. Acute perimenstrual withdrawal from ovarian steroids may play a causal role in perimenstrual worsening of depression and SI.

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The pharmacotherapeutic management of premenstrual dysphoric disorder

Ciccone

Kovacheff

Frey

2022

Expert Opinion on Pharmacotherapy

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Understanding menstrual cycle effects on suicide will require prospective studies of suicidal thoughts and behaviors in premenstrual disorders

Cited by 5 publications

References 10 publications

A DSM-5-based tool to monitor concurrent mood and premenstrual symptoms: the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS)

A DSM-5-based tool to monitor concurrent mood and premenstrual symptoms: the McMaster Premenstrual and Mood Symptom Scale (MAC-PMSS)

Effects of acute estradiol and progesterone on perimenstrual exacerbation of suicidal ideation and related symptoms: a crossover randomized controlled trial

The pharmacotherapeutic management of premenstrual dysphoric disorder

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