Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study

Qiu-Yue Dong; Xiao-Fan Yang; Bao-Peng Liu; Ying-Ying Zhang; Li-Peng Wan; Cun-Xian Jia

doi:10.1016/j.jad.2023.02.041

Menstrual pain mediated the association between daytime sleepiness and suicidal risk: A prospective study

J Affect Disord. 2023 May 1:328:238-244. doi: 10.1016/j.jad.2023.02.041. Epub 2023 Feb 17.

Authors

Qiu-Yue Dong¹, Xiao-Fan Yang¹, Bao-Peng Liu¹, Ying-Ying Zhang¹, Li-Peng Wan¹, Cun-Xian Jia²

Affiliations

¹ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
² Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China; Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China. Electronic address: jiacunxian@sdu.edu.cn.

PMID: 36806594
DOI: 10.1016/j.jad.2023.02.041

Abstract

Background: Adolescents with daytime sleepiness have been demonstrated to have a higher level of suicidal risk than those without. Currently, few studies had examined the pathway from daytime sleepiness to suicidal risk among female adolescents. This study aimed to explore the association among menstrual pain, daytime sleepiness, and suicidal risk among female adolescents in China.

Methods: Of 7072 adolescents who participated in the follow-up survey of Shandong Adolescents Behavior & Health Cohort (SABHC), 3001 were female adolescents who had begun to menstruate and included for the analysis. A structured self-administrated questionnaire was used to measure menstrual pain, daytime sleepiness, suicidal risk and demographic characteristics. Participants were first surveyed in November-December 2015 and resurveyed 1 year later.

Results: Of 3001 participants, 11.43 % had suicidal risk, 79.8 % experienced menstrual pain. Cross-lagged analysis showed that there was cause-and-effect relationship between menstrual pain and daytime sleepiness. Moderate (OR = 1.79, 95%CI: 1.22-2.63) and severe (OR = 2.73, 95%CI: 1.80-4.12) menstrual pain (follow-up) were associated with suicidal risk (follow-up). Daytime sleepiness (baseline: OR = 1.04, 95%CI: 1.02-1.06, follow-up: OR = 1.07, 95%CI: 1.05-1.09) had effects on suicidal risk (follow-up). Mediation analysis showed that menstrual pain played a partially mediating role between daytime sleepiness and suicidal risk, with the indirect effect being 0.002 (95%CI: 0.001-0.004).

Limitations: All data were self-reported.

Conclusions: Menstrual pain and daytime sleepiness had effects on each other, and they both were the risk factors of suicidal risk. Among female adolescents, the association between daytime sleepiness and suicidal risk could be partially mediated by menstrual pain. Releasing the menstrual pain of female adolescents with daytime sleepiness could reduce their suicidal risk.

Keywords: Adolescents; Cross-lagged analysis; Daytime sleepiness; Mediator; Menstrual pain; Suicidal risk.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Disorders of Excessive Somnolence*
Dysmenorrhea*
Female
Humans
Male
Prospective Studies
Suicidal Ideation
Surveys and Questionnaires