Joffe Hadine, Hall Janet E, Soares Claudio N, Hennen John, Reilly Caragh J, Carlson Karen, Cohen Lee S
Perinatal and Reproductive Psychiatry Program, Reproductive Endocrine Unit, and Medical Service, Massachusetts General Hospital, Boston, MA, USA.
Menopause. 2002 Nov-Dec;9(6):392-8. doi: 10.1097/00042192-200211000-00003.
To compare the relationship between vasomotor symptoms (hot flushes and night sweats) and depression in perimenopausal women with that in postmenopausal and older premenopausal women.
Questionnaire data assessing current depressive symptoms (Center for Epidemiologic Studies Depression Scale), hot flushes, night sweats, menopausal status, depression history, hormonal therapy use, and demographic characteristics were collected from women aged 40 to 60 years seeking primary care. Multivariable logistic regression models were used to examine the relationship between vasomotor symptoms and depression.
Depression (defined by a Center for Epidemiologic Studies Depression Scale score >/= 25) was observed in 14.9% of 141 perimenopausal women, 13.9% of 151 postmenopausal women, and 7.6% of 184 older premenopausal women. Recent vasomotor symptoms were reported by 53.9% of perimenopausal women, 43.7% of postmenopausal women, and 20.7% of older premenopausal women. Perimenopausal women with vasomotor symptoms were 4.39 times more likely to be depressed than those without vasomotor symptoms (95% CI, 1.40-13.83), an association that did not change after controlling for depression history. In contrast with perimenopausal women, postmenopausal and older premenopausal women with vasomotor symptoms did not have a significantly greater risk for depression than women of the same menopausal status without vasomotor symptoms (adjusted odds ratios, 1.28 and 1.77; 95% CI, 0.47-3.46 and 0.53-5.89, respectively).
Hot flushes and night sweats are associated with depression in perimenopausal women. Further investigation is warranted to elucidate the mechanism by which hot flushes may be associated with depression in perimenopausal women and not in postmenopausal or older premenopausal women.
比较围绝经期女性血管舒缩症状(潮热和盗汗)与抑郁之间的关系,以及绝经后女性和绝经前老年女性的情况。
收集40至60岁寻求初级保健的女性的问卷数据,评估当前抑郁症状(流行病学研究中心抑郁量表)、潮热、盗汗、绝经状态、抑郁病史、激素治疗使用情况和人口统计学特征。采用多变量逻辑回归模型来研究血管舒缩症状与抑郁之间的关系。
在141名围绝经期女性中,14.9%存在抑郁(由流行病学研究中心抑郁量表评分≥25定义);151名绝经后女性中,13.9%存在抑郁;184名绝经前老年女性中,7.6%存在抑郁。53.9%的围绝经期女性、43.7%的绝经后女性和20.7%的绝经前老年女性报告有近期血管舒缩症状。有血管舒缩症状的围绝经期女性患抑郁症的可能性是没有血管舒缩症状女性的4.39倍(95%可信区间,1.40 - 13.83),在控制抑郁病史后,这种关联没有改变。与围绝经期女性不同,有血管舒缩症状的绝经后女性和绝经前老年女性患抑郁症的风险并不比没有血管舒缩症状的同绝经状态女性显著更高(调整后的优势比分别为1.28和1.77;95%可信区间分别为0.47 - 3.46和0.53 - 5.89)。
潮热和盗汗与围绝经期女性的抑郁有关。有必要进一步研究以阐明潮热可能与围绝经期女性而非绝经后或绝经前老年女性的抑郁相关的机制。