Citation

García EB, Blasco-Fontecilla H, Domínguez AC, Pérez-Rodríguez MM, Ruiz JS. Psychiatr. Danub. 2006; 18(Suppl 1): 73.

Affiliation

Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Av. Reyes Catolicos 2, Madrid 28040, Spain. ebacgar2@yahoo.es.

Copyright

(Copyright © 2006, Facultas Universitatis Studiorum Zagrabiensis - Danube Symposion of Psychiatry)

DOI

unavailable

PMID

16963979

Abstract

The differences in prevalence and natural history of psychiatric disorders in men and women suggest that sexual hormones modify the expression of psychopathological alterations. Suicidal behavior may be an example of sexually dimorphic behavior, under the influence of sexual steroids. The hormonal changes that occur during the menstrual cycle and their effect on suicide behavior provide an excellent opportunity to analyze this influence. The results of the studies on the interaction between the menstrual cycle and suicide behavior offer several different interpretations. Some authors deny any significant role of the menstrual cycle in suicide behavior; others believe that the menstrual alterations found in some samples are a result of suicidal behavior, and others consider the menstrual cycle to be the trigger of an acute psychiatric disorder or a predictor of the timing of the suicide attempts. In between these extreme points of view lies the hypothesis that proposes that certain phases of the menstrual cycle represent a period of higher vulnerability in some women, a state marker for certain patterns of suicide behavior. Notwithstanding their limitations, most studies have found an increased rate of suicide attempts in the luteal phase and an increased rate of completed suicides in the menstrual phase. This effect of estrogens on suicide behavior may be mediated by their actions on the serotonergic system. The scientific literature supports the possibility that -in a vulnerability model- hyposerotonergic states may constitute a predisposition or diathesis factor, and hormonal levels may act as a triggering factor. These models are based on two assumptions: 1) the existence of a central hyposerotonergic state as a predisposing factor or diathesis for suicidal behavior; 2) hormonal changes are a stressor or triggering factor that contributes to serotonergic hypofunction in the brain. Thus, the interaction of an alteration of serotonergic function (maybe genetically determined) and a hormonal environment that enhances this alteration results in a state of predisposition or diathesis for the development of self harming or impulsive behavior in women, in the concurrence of the appropriate triggers.

Language: en