围绝经期、抑郁障碍与激素变化
The perimenopause, depressive disorders, and hormonal variability.
作者信息
Soares C N, Cohen L S
机构信息
Perinatal and Reproductive Psychiatry Clinical Research Program, Center for Women's Mental Health, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
出版信息
Sao Paulo Med J. 2001 Mar;119(2):78-83. doi: 10.1590/s1516-31802001000200008.
CONTEXT
Several investigations have postulated that the perimenopause may represent a period of increased psychiatric vulnerability, particularly for mood disorders. This review characterizes the perimenopause, including biological changes, the influence of psychosocial factors and the most common clinical manifestations. Clinic-based studies and community-based surveys addressing the prevalence of depressive symptoms in perimenopausal women are critically reviewed. We also discuss the potential greater vulnerability to mood disturbance during the perimenopause in response to hormonal variability. A therapeutic algorithm for management of depressive symptoms in middle-aged perimenopausal women is also presented. The role of estrogen in the treatment of perimenopausal depressive symptoms is particularly discussed. In addition, we review the existing data regarding the potential efficacy of estrogen as an antidepressant agent (monotherapy, augmentation strategy or prophylaxis).
DESIGN
Narrative review.
背景
多项研究推测，围绝经期可能是精神疾病易感性增加的时期，尤其是情绪障碍。本综述对围绝经期进行了描述，包括生物学变化、心理社会因素的影响以及最常见的临床表现。对基于诊所的研究和基于社区的调查进行了严格审查，这些研究调查了围绝经期女性抑郁症状的患病率。我们还讨论了围绝经期因激素变化而对情绪障碍潜在的更高易感性。还提出了一种治疗中年围绝经期女性抑郁症状的治疗算法。特别讨论了雌激素在治疗围绝经期抑郁症状中的作用。此外，我们回顾了有关雌激素作为抗抑郁药（单一疗法、增效策略或预防）潜在疗效的现有数据。
设计
叙述性综述。
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