Premenstrual Disorders Increase Suicide Risk: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in JAMA Network Open that examined the association between premenstrual disorders (PMDs) and overall and cause-specific mortality.

The study

Researchers conducted the nationwide, population-based cohort study using data from Swedish national health and population registers. A total of 67 748 women of reproductive age who had a first diagnosis of PMD from 2001 to 2018 were identified and matched in a ratio of 5:1 with 338 740 women without PMD, for a final cohort numbering 406 488 women.

Participants were followed until death, emigration, or December 31, 2018, whichever came first. Investigators defined the primary outcomes as dates of death and underlying causes, which were retrieved from the National Cause of Death Register.

The findings

Researchers found no increase in overall mortality risk for women with vs without PMD (aHR, 0.91; 95% CI, 0.82-1.02). The risk for death from unnatural causes, however, was greater among study participants with PMD compared with those without (HR, 1.59; 95% CI, 1.25-2.04). Moreover, that risk was nearly 2 times greater for death from suicide (aHR, 1.92; 95% CI, 1.43-2.6) and was consistent regardless of age at PMD diagnosis.

There was a slightly lower risk for all-cause mortality after accounting for demographics and comorbidities, the investigators reported, which was seen mainly among women diagnosed with PMDs at the somewhat older ages between 45 to 51 years (HR, 0.79; 95% CI, 0.64-0.97). In contrast, among women diagnosed before the age of 25 years, the risk of all-cause mortality was more than doubled (HR, 2.51; 95% CI, 1.42-4.42).

Authors' comment

"These findings suggest that women with PMDs are not at increased risk of all-cause mortality, but active surveillance might be needed among young patients and for suicide prevention for all ages."

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