Suicide is a leading cause of death among females of reproductive age. The menstrual cycle is a plausible yet understudied trigger for acute suicide risk. Cross-sectional studies have demonstrated a greater frequency of suicide attempts and deaths in the weeks before and after the onset of menses compared to other cycle phases. Here, using prospective daily ratings, we examine the relationship between the cycle and suicidal ideation (SI) and related symptoms known to show a cyclical change in some patients (depression, hopelessness, guilt, rejection sensitivity, interpersonal conflict, anxiety, mood swings, and anger/irritability). Thirty-eight naturally cycling outpatients recruited for past-month SI reported SI severity and other symptoms across an average of 40 days. Participants were excluded for hormone use, pregnancy, irregular cycles, serious medical illness, and body mass index > 29.9 or < 18. Intraclass correlations ranged from .29 to .46, highlighting that most symptom variance lies within-person. Cyclical worsening of symptoms was evaluated using phase contrasts in multilevel models. Most symptoms, including SI, were significantly worse in the perimenstrual phase than in all other phases. Additionally, anger/irritability was higher in the midluteal than in the midfollicular phase, and several symptoms of depression were higher in the midfollicular than in the periovulatory phase. Otherwise, symptoms did not significantly differ between the midluteal, midfollicular, and periovulatory phases. Cycle phase predictors accounted for 25% of the within-person variance in SI. Females with SI may be at risk for perimenstrual worsening of SI and related symptoms. These findings highlight the importance of assessing the cycle phase for improved prediction of suicide risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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女性门诊患者自杀意念的周期性加剧：来自跨诊断样本每日评级的前瞻性证据。

自杀是育龄女性死亡的主要原因。月经周期是急性自杀风险的一个看似合理但尚未得到充分研究的触发因素。横断面研究表明，与其他月经周期阶段相比，月经来潮前后几周的自杀企图和死亡频率更高。在这里，我们使用前瞻性每日评级，检查周期与自杀意念（SI）之间的关系以及已知在某些患者中表现出周期性变化的相关症状（抑郁、绝望、内疚、拒绝敏感、人际冲突、焦虑、情绪波动、和愤怒/烦躁）。38 名接受上个月 SI 招募的自然循环门诊患者报告了平均 40 天内的 SI 严重程度和其他症状。参与者因激素使用、怀孕、周期不规律、严重疾病和体重指数 > 29.9 或 < 18 被排除。组内相关性范围为 0.29 至 0.46，突出显示大多数症状差异存在于人体内。使用多级模型中的相差来评估症状的周期性恶化。大多数症状，包括 SI，在围经期明显比所有其他阶段更严重。此外，黄体中期的愤怒/烦躁程度高于卵泡中期，并且卵泡中期的几种抑郁症状高于排卵期。除此之外，黄体中期、卵泡中期和排卵期期间的症状没有显着差异。周期阶段预测因素占 SI 人内方差的 25%。患有 SI 的女性可能面临经期 SI 和相关症状恶化的风险。这些发现强调了评估周期阶段对于改善自杀风险预测的重要性。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。