Department of Psychiatry at the New York State Psychiatric Institute and Columbia University, NY, USA.
J Psychiatr Res. 2010 Mar;44(4):209-14. doi: 10.1016/j.jpsychires.2009.08.004. Epub 2009 Sep 25.
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.
月经周期与自杀行为风险之间的关系尚不清楚。本研究旨在确定生育期女性的经前期是否与自杀未遂的急性风险相关，并探讨在雌二醇/孕酮水平较低时风险是否升高。在自杀未遂后 24 小时内招募了 431 名女性，评估了她们的精神病理学、自杀行为以及 LH、FSH、雌二醇和孕酮的血液水平。在 281 名生育期女性中（431 名中的），自杀未遂更可能发生在月经期（26%，72/281 观察到的尝试与 15%，43/281 预期的尝试；p<0.001）。与那些在其他阶段发生尝试的女性相比，在雌二醇/孕酮水平较低时（月经期、闭经和绝经期）发生自杀未遂的女性报告了严重的自杀意图，这一指标可能预示着最终的自杀死亡。当雌激素和孕激素水平较低时，女性更有可能自杀未遂，而在这些情况下进行的尝试与更严重的自杀行为相关。低性腺激素水平可能是女性自杀行为神经生物学基础的关键因素，这为自杀行为的潜在机制提供了一个新的、可测试的假设。
