A Longitudinal Evaluation of the Relationship Between Reproductive Status and Mood in Perimenopausal Women

Behavioral Endocrinology Branch, NIMH, NIH, Department of Health and Human Services, Rm. 3N238, Bldg. 10, 10 Center Dr., MSC 1276, Bethesda, MD 20892-1276, USA.
American Journal of Psychiatry (Impact Factor: 13.56). 01/2005; 161(12):2238-44. DOI: 10.1176/appi.ajp.161.12.2238
Source: PubMed

ABSTRACT Mood and reproductive function were prospectively evaluated in asymptomatic premenopausal women to determine whether the onset of depression was temporally linked to the perimenopause.
Twenty-nine asymptomatic, regularly cycling women were monitored longitudinally for an average of 5 years until at least 6 months of amenorrhea occurred. Outcome measures included mood ratings and menstrual diaries completed daily, the Structured Clinical Interview for DSM-IV, and plasma levels of follicle-stimulating hormone obtained at 3-6-month intervals. The number of episodes of depression and their timing relative to the final menstrual period were determined. Differences in outcome measures between women who did and did not become depressed during the perimenopause were determined by Student's t test, chi-square tests, and Fisher's exact test.
The authors observed 11 episodes of new-onset depression in nine of the 29 women. In the 24 months surrounding the last menstrual period nine episodes of depression were observed. Six of the nine women who became depressed during the study had no prior depressive episodes. For the 24 months surrounding the final menses, the risk for onset of depression was 14 times as high as for a 31-year premenopausal period of time. Women who developed depression during the perimenopause were not distinguished from those who remained asymptomatic on the basis of symptom profile, duration of the perimenopause, endocrine measures, or past historical variables.
These preliminary data suggest that events related to the late perimenopause may be associated with an increased susceptibility to develop depression in some women.

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    • "A number of risk factors have been identified, which might result in menopausal women experiencing more or less depression or depressive symptoms. These include VMS [19], hormonal vulnerability [20], socioeconomic status (SES), education and achievement (higher SES, education and income resulting in less depressive symptoms), smoking, exercise, body mass index (BMI), social support and partner status, coping, attitude, stressful life events and past history of mood disorder [21]. "
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    ABSTRACT: There is evidence that menopausal symptoms manifested at peri-menopause occur less frequently when compared to the symptoms experienced at post-menopause. The aim of this study was to investigate this and to test the hypothesis that depressive symptomatology mediates the relationship between menopausal stage and symptom frequency. This cross-sectional study included 213 women (M age=52 years), of whom 125 were peri- and 88 post-menopausal. Measures comprised the Center for Epidemiologic Studies-Depression scale (CES-D) and the Women's Health Questionnaire (WHQ) vasomotor symptoms and somatic symptoms subscales. Multiple mediated regression analyses provided evidence that somatic symptoms and vasomotor symptoms were less frequent at post- compared to peri-menopause, and that these differences were mediated by depressive symptomatology. Multivariate effect sizes ranged from small to moderate, and univariate effect sizes were uniformly small with wide confidence intervals. The frequency of vasomotor and somatic symptoms appears to increase with depressed affect. The management of symptoms could include interventions of a psychotherapeutic nature, which may offset this effect, particularly in women for whom depressive symptoms are a feature of the climacteric syndrome. The extent to which depression and the climacteric syndrome may be causally related to one another remains unclear and longitudinal research should further examine the mechanisms of this association. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
    Maturitas 03/2015; 289(2). DOI:10.1016/j.maturitas.2015.03.007 · 2.86 Impact Factor
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    • "Many of the studies reviewed had methodological limitations, such as high risk of bias from poorly representative study populations , lack of random selection, missing information and using unvalidated measures of VMS [11] [22] [30] [32]. Small sample sizes [38] [46] and unadjusted analyses limit the applicability of other Table 3 Cohort studies that assessed the likelihood of women with VMS developing depressive symptoms. "
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    ABSTRACT: There is a high incidence of depression in women presenting to menopause clinics. The aim of this review was to determine if there is an association between depressive symptoms or major depressive disorder (MDD) and vasomotor symptoms (VMS). A systematic review of the literature was conducted according to PRISMA guidelines. 33 relevant publications were found, 12 from three large studies. Overall, we found that there is a bidirectional association between VMS and depressive symptoms. This has been established in well-conducted, large observational studies. There does not appear to be a relationship between VMS and MDD. However, studies examining VMS and MDD were prone to bias making it difficult to draw any conclusions.
    Maturitas 12/2013; 77(2). DOI:10.1016/j.maturitas.2013.11.007 · 2.86 Impact Factor
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    • "The mechanism of the pathogenesis of psychiatric disorders during menopausal transition remains controversial possibly because of the few studies utilizing rigorous measurements such as The Structured Clinical Interview for DSM-IV (SCID). By utilizing the SCID for women without a current or past history of depression, Schmidt et al. (2004) have revealed that the risk for onset of depression is 14 times as high as for a 31-year premenopausal period of time. In the Study of Women's Health Across the Nation (SWAN), Bromberger et al. (2009) initially reported no association between the perimenopausal period and the risk for onset of depression diagnosed by SCID, but afterward, they have reported that the risk of major depression is greater for women during and immediately after the menopausal transition than for women during the premenopausal period (Bromberger et al., 2011). "
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    Frontiers in Integrative Neuroscience 07/2013; 7:53. DOI:10.3389/fnint.2013.00053
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