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

Excerpt

The past 50 years of suicide research have produced a small set of distal, between-person factors that predict suicide attempts only slightly better than chance, and rates of suicide death have not declined over the same timeframe [1]. In order to prevent suicide, it is critical to identify time-varying factors that predict acute changes in risk, allowing for targeted intervention in the days and weeks where individuals are most vulnerable. Ample cross-sectional data indicate that some individuals experience menstrual cycle-related changes in suicidal behavior and associated risk factors [2], suggesting that hormone fluctuations across the menstrual cycle may be one predictable time-varying trigger for acute increases in suicide risk. In a field that has largely fallen short of identifying such triggers, the present study makes an important contribution by highlighting a vulnerable group who may experience a reliable pattern of change in risk. However, this area of research faces several barriers to advancement, including the need for replication in prospectively confirmed premenstrual dysphoric disorder (PMDD) and the urgent need to integrate suicidality into our scientific and clinical conceptualizations of PMDD. …