{
    "abstract": "Premenstrual disorders (PMDs) adversely affect the quality of life of millions of women worldwide, yet research on the long-term consequences of PMDs is limited, and the risk of mortality has not been explored.\nTo estimate the associations of PMDs with overall and cause-specific mortality.\nThis nationwide, population-based, matched cohort study used data from population and health registers in Sweden. Participants included women of reproductive age with a first diagnosis of PMDs between January 1, 2001, and December 31, 2018. Data analysis was performed from September 2022 to April 2023.\nPMDs were identified through inpatient and outpatient diagnoses and drug dispensing.\nDates of death and underlying causes were ascertained from the National Cause of Death Register. Conditional Cox regression was used to estimate the hazard ratios (HRs) of overall and cause-specific death (eg, death due to natural or nonnatural cause, suicide, or cardiovascular events), adjusting for age, socioeconomic status, and somatic and psychiatric comorbidities; in a separate sibling comparison, models were also adjusted for all factors that sisters share.\nA total of 67\u202f748 women with clinically diagnosed PMDs and 338\u202f740 matched unaffected women were included, for a total of 406\u202f488 women. Women with PMDs received a diagnosis at a mean (SD) age of 35.8 (8.2) years. During a mean (SD) follow-up of 6.2 (4.6) years (range, 1-18 years), 367 deaths were observed among women with PMDs (rate, 8.4 deaths per 10\u202f000 person-years; 95% CI, 7.6-9.3 deaths per 10\u202f000 person-years), and 1958 deaths were observed among women without PMDs (rate, 9.1 deaths per 10\u202f000 person-years; 95% CI, 8.7-9.6 deaths per 10\u202f000 person-years). Compared with unaffected women, women with PMDs had increased risk of death due to nonnatural causes (HR, 1.59; 95% CI, 1.25-2.04), particularly suicide (HR, 1.92; 95% CI, 1.43-2.60), but they did not have increased risk of overall mortality (adjusted HR, 0.91; 95% CI, 0.82-1.02). Notably, women who received a diagnosis before the age of 25 years experienced higher all-cause mortality (HR, 2.51; 95% CI, 1.42-4.42) and death from both suicide (HR, 3.84; 95% CI, 1.18-12.45) and natural causes (HR, 2.59; 95% CI, 1.21-5.54).\nThe findings of this matched cohort study suggest that women with PMDs are not at increased risk of early death overall. However, the risk was elevated among young women and for death by suicide. This supports the importance of careful follow-up for young patients and highlights the need to develop suicide prevention strategies for all women with PMDs.",
    "authors": [
        {
            "affiliation": "Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.",
            "firstname": "Marion",
            "initials": "M",
            "lastname": "Opatowski"
        },
        {
            "affiliation": "Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.\nDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.\nCenter of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjav\u00edk, Iceland.",
            "firstname": "Unnur Anna",
            "initials": "UA",
            "lastname": "Valdimarsd\u00f3ttir"
        },
        {
            "affiliation": "Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.",
            "firstname": "Anna Sara",
            "initials": "AS",
            "lastname": "Oberg"
        },
        {
            "affiliation": "Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst.\nDepartment of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst.",
            "firstname": "Elizabeth R",
            "initials": "ER",
            "lastname": "Bertone-Johnson"
        },
        {
            "affiliation": "Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.",
            "firstname": "Donghao",
            "initials": "D",
            "lastname": "Lu"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1001/jamanetworkopen.2024.13394\n10.1016/j.ajog.2017.05.045\n10.1007/s11920-015-0628-3\n10.1300/J013v39n03_03\n10.1089/jwh.2007.0417\n10.1093/aje/kwv159\n10.1016/j.maturitas.2020.08.006\n10.1111/j.1464-5491.1993.tb00096.x\n10.1007/s00737-003-0027-3\n10.2215/CJN.06730711\n10.1016/j.psychres.2020.113702\n10.1001/jamapsychiatry.2014.2502\n10.1186/s12916-021-01989-4\n10.1007/s00737-020-01054-8\n10.1016/S0140-6736(07)61602-X\n10.1007/s10654-016-0117-y\n10.1111/j.1651-2227.1991.tb11758.x\n10.1093/humrep/dev017\n10.1186/1471-2458-11-450\n10.1016/j.jclinepi.2009.01.010\n10.1007/s10654-017-0316-1\n10.1111/j.0954-6820.1976.tb08223.x\n10.1089/jwh.2015.5636\n10.1001/jamanetworkopen.2022.1256\n10.1089/jwh.2016.5937\n10.2147/CLEP.S282475\n10.1111/1471-0528.14260\n10.1186/1478-7954-12-11\n10.1136/bmjopen-2015-009120\n10.1192/bjp.178.5.465\n10.1186/s12905-020-01100-8\n10.1007/s00127-012-0548-z\n10.1016/S2468-2667(19)30155-0\n10.1093/eurheartj/ehac364\n10.1016/j.maturitas.2009.08.003\n10.4103/1735-1995.189647\n10.1097/YIC.0b013e32835d735d\n10.1097/PPO.0000000000000591\n10.1186/s12916-018-1101-z\n10.1186/1477-7819-11-101\n10.1210/jcem.75.2.1639955\n10.1089/jwh.1998.7.893\n10.1177/1403494813499653\n10.1093/aje/kwn194\n10.1001/jama.284.6.706\n10.21037/atm.2017.03.107",
    "journal": "JAMA network open",
    "keywords": [],
    "methods": null,
    "publication_date": "2024-05-28",
    "pubmed_id": "38805225\n28571724\n26377947\n15256354\n18240988\n26601989\n33308624\n8334824\n14963731\n9427873\n22490873\n33418461\n25671328\n34034729\n32936329\n18064739\n26769609\n1755302\n25662809\n21658213\n19364635\n28983736\n970229\n27420549\n35258576\n27268465\n33469380\n27900828\n24739594\n26608638\n11331564\n33115437\n22752111\n31588031\n36239217\n19733988\n27904611\n23325305\n35594469\n30025524\n25250125\n23688389\n1639955\n9785316\n23982462\n18701443\n10927778\n28480197",
    "results": "A total of 67\u202f748 women with clinically diagnosed PMDs and 338\u202f740 matched unaffected women were included, for a total of 406\u202f488 women. Women with PMDs received a diagnosis at a mean (SD) age of 35.8 (8.2) years. During a mean (SD) follow-up of 6.2 (4.6) years (range, 1-18 years), 367 deaths were observed among women with PMDs (rate, 8.4 deaths per 10\u202f000 person-years; 95% CI, 7.6-9.3 deaths per 10\u202f000 person-years), and 1958 deaths were observed among women without PMDs (rate, 9.1 deaths per 10\u202f000 person-years; 95% CI, 8.7-9.6 deaths per 10\u202f000 person-years). Compared with unaffected women, women with PMDs had increased risk of death due to nonnatural causes (HR, 1.59; 95% CI, 1.25-2.04), particularly suicide (HR, 1.92; 95% CI, 1.43-2.60), but they did not have increased risk of overall mortality (adjusted HR, 0.91; 95% CI, 0.82-1.02). Notably, women who received a diagnosis before the age of 25 years experienced higher all-cause mortality (HR, 2.51; 95% CI, 1.42-4.42) and death from both suicide (HR, 3.84; 95% CI, 1.18-12.45) and natural causes (HR, 2.59; 95% CI, 1.21-5.54).",
    "title": "Mortality Risk Among Women With Premenstrual Disorders in Sweden.",
    "xml": "<Element 'PubmedArticle' at 0x788502c4a700>"
}