Context
- Females demonstrate greater depression, suicidal ideation (SI), and suicide attempts than males between puberty and menopause.
- Suicide attempts most frequently occur around menses, when estradiol (E2) and progesterone (P4) fall rapidly (following luteal elevation).
Grants
- K99MH109667
- R00MH109667
- RF1MH180243
- R01MH122446
Papers
Patients with current suicidality are at high risk of cyclical hormone sensitivity
- Cyclical worsening of affective and suicide symptoms is dimensional (present to varying degrees) in patients recruited for suicidal ideation
- … and can be statistically accounted for by perimenstrual increases in depressed mood, hopelessness, anhedonia, and perceived burdensomeness to others.
Predicting Acute Changes in Suicidal Ideation and Planning: A Longitudinal Study of Symptom Mediators and the Role of the Menstrual Cycle in Female Psychiatric Outpatients With Suicidality
Ross, J. M., Barone, J., Tauseef, H., Schmalenberger, K. M., Nagpal, A.*, Crane, N. A., & Eisenlohr-Moul, T. (2023). What predicts acute changes in suicidal ideation and planning? A longitudinal study of symptom mediators and the role of the menstrual cycle in female psychiatric outpatients with suicidality. The American Journal of Psychiatry.
Patients with cyclical hormone sensitivity are at high lifetime risk of suicidality
- Patients reporting prospective diagnosis with PMDD report high lifetime prevalence of suicidal thoughts (72%) and suicide attempts (34%).
- Note: this was recently replicated/extended by colleagues here.
Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder - BMC Psychiatry
Eisenlohr-Moul, T., Divine, M., Schmalenberger, K., Murphy, L., Buchert, B., Wagner-Schuman, M., ... & Ross, J. (2022). Prevalence of lifetime self-injurious thoughts and behaviors in a global sample of 599 patients reporting prospectively confirmed diagnosis with premenstrual dysphoric disorder. BMC psychiatry, 22(1), 199.
A large number of (RDoC) hormone-behavior pathways may promote cyclical suicidality
- In this review, my prior PhD student Sarah Owens McHugh reviews the evidence for hormone/hormone sensitivity effects on RDoC constructs that are known to be relevant to suicidality.
Suicide Risk and the Menstrual Cycle: a Review of Candidate RDoC Mechanisms
Owens, S. A., & Eisenlohr-Moul, T. (2018). Suicide risk and the menstrual cycle: a review of candidate RDoC mechanisms. Current psychiatry reports, 20, 1-11.