DALTON,1 after analyzing admission records in two large English mental hospitals, reported an interesting relationship between phase of the menstrual cycle and time of admission for (1) acute psychiatric disturbance, (2) attempted suicide, and (3) depressive illness. In each of these categories, the highest incidence occurred during the first four days of menstruation; the second highest was during the four premenstrual days, and the third highest was in midcycle. Because of the lag factors involved with hospital admission (calling, scheduling, etc), we wondered if the maximum psychiatric disturbance was actually in the premenstrual period (more popularly believed to be the time of maximum upset) rather than in the early menstrual days as indicated in this study. An opportunity to use what we thought would be a more responsive variable, requiring less time and movement on the part of the patient, became available to us—telephone calls to the Los Angeles
Mandell AJ, Mandell MP. Suicide and the Menstrual Cycle. JAMA. 1967;200(9):792–793. doi:10.1001/jama.1967.03120220094022
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