Perimenstrual Vulnerability and Psychiatric Symptom Severity Among Women with Mental Illness in Jamaica: A Transdiagnostic Cross-Sectional Study

Abstract Purpose Anecdotal observation at a teaching hospital in Jamaica suggested increased admissions amongst women at the time of or near the onset of their menses. This study investigates menstrual cycle phase association to psychiatric symptom severity with primary psychiatric diagnosis as a covariate. Method A comprehensive study questionnaire was applied to eligible inpatients and outpatients that recorded whether they were in the perimenstrual phase of their menstrual cycle or not as well as primary psychiatric diagnosis. The Brief Psychiatric Rating Scale (BPRS) was used to measure clinical severity in addition to urine screens for pregnancy, cannabis or cocaine use. Statistical analyses included the Mann Whitney U and linear regression tests to explore the primary relationship and covariate effect. Results n=96 inpatient and outpatient females of reproductive years with a psychiatric diagnosis. Mean BPRS scores were higher among the group in perimenstrual phase, 33.9 ± 9.3, versus the group in the non-perimenstrual at 29.5 ± 8.7 and was of statistically significance p value = 0.024. Individual diagnoses of schizophrenia and MDD were associated with higher BPRS scores, however, the primary relationship was independent of psychiatric diagnosis as a covariate. Conclusion Demonstration of the perimenstrual phase of the menstrual cycle being associated with worsening mental health in women, irrespective of primary psychiatric diagnosis, increases mental health literacy for women and practitioners. This study adds to the exploration of the menstrual cycle’s role in mental health, enabling the local application of sex specific strategies in the management of clients at individual and systematic levels.