(PS13-52) The Relationship Between Menstrual Cycle and Suicidal Ideation and Behavior in Adolescent Females Admitted to an Inpatient Psychiatric Unit

Rates of suicidality in adolescent girls have been increasing in recent decades (CDC, 2023), with girls attempting suicide over twice as often as adolescent boys (Kann, 2016). The sudden doubling of rates of suicidal ideation and behavior at the onset of puberty point to the potential of hormonal shifts impacting rates of suicidality. The connection between reproductive hormones and suicidality has been well documented in adult women, with women experiencing increased rates of suicidality during the perimenstrual phase of the menstrual cycle (Baca-Garcia, et al., 2010; Papadopoulou et al., 2019). This connection has not been directly examined in adolescents, however. The present study examined if 1) menstrual phase was related to suicidal ideation, plans, and attempts, 2) if menstrual phase was associated with more severe suicidal behavior, 3) if comorbid psychiatric diagnoses affected the relationship between menstrual phase and suicidal ideation and behavior, and 4) if age impacted the relationship between menstrual phase and suicidal ideation and behavior in a sample of adolescent girls (n = 169) admitted for acute psychiatric care.

An exact binomial test was used to determine if girls were admitted more often during the perimenstrual phase of their menstrual cycle than would be expected if there was no impact. 65% of girls were admitted during the perimenstrual phase, significantly more than the 31% expected if there was no impact from menstrual phase, p < .001. A chi-square goodness-of-fit test also found that admission was not equally distributed across the five menstrual phases, X² (4, n = 169) = 19.118, p  < .001. Chi-square tests of independence were performed to examine the relationship between menstrual phase and suicidal ideation, plans, and attempts. Results indicated that the relationship was not statistically significant when menstrual phase was divided into five phases, X² (8, n = 169) = 5.160, p = .740, or when menstrual phase was divided into perimenstrual and non-perimenstrual phase, X² (2, n = 169) = 2.296, p = .317. There was not a statistically significant difference in suicidal presentation across the five menstrual phases, X² (4 , n = 169) = .785, p = .940, or between perimenstrual and other phases,  X² (1 , n = 169) = .715, p = .398. The relationship between menstrual phase and suicidal ideation, plans, and attempts was statistically significant for those with a diagnosis of PTSD, X² (1, n = 169) = 4.354, p = .037, but not in those without PTSD. The relationship between menstrual phase and suicidal ideation and behavior did not differ based on diagnosis of anxiety or depression at admission. These potential moderators will be discussed more in depth in the poster, as will implications and future directions.