Bromberger Joyce T, Assmann Susan F, Avis Nancy E, Schocken Miriam, Kravitz Howard M, Cordal Adriana
Departments of Epidemiology and Psychiatry, Graduate School of Public Health, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
Am J Epidemiol. 2003 Aug 15;158(4):347-56. doi: 10.1093/aje/kwg155.
To further our understanding of the relation between mood and menopause, the authors examined 1) the association between persistent mood symptoms and menopausal status and 2) factors that increase a woman's vulnerability to an overall dysphoric mood during the early perimenopausal period. The sample consisted of an ethnically diverse community cohort of 3,302 pre- and early perimenopausal women aged 42-52 years who were participants in the Study of Women's Health Across the Nation, an ongoing US multisite longitudinal study of menopause and aging. At study entry (1995-1997), women reported information on recent menstrual regularity and premenstrual symptoms, as well as on sociodemographic, symptom, health, sleep, psychosocial, and lifestyle variables. Rates of persistent mood symptoms were higher among early perimenopausal women (14.9%-18.4%) than among premenopausal women (8%-12%). In analyses adjusting for major covariates and confounders, early perimenopausal women had higher odds of irritability, nervousness, and frequent mood changes but not of feeling "blue." The effect of being early perimenopausal on overall dysphoric mood was greatest among women with an educational level of less than high school graduation. These findings suggest that persistent mood symptoms and overall dysphoric mood are associated with the early perimenopause, particularly among women with lower educational attainment.
为了进一步加深我们对情绪与更年期之间关系的理解，作者研究了：1）持续性情绪症状与绝经状态之间的关联；2）在围绝经期早期增加女性整体烦躁情绪易感性的因素。样本包括一个种族多样化的社区队列，共3302名年龄在42至52岁之间的绝经前和围绝经期早期女性，她们是“全国女性健康研究”的参与者，该研究是美国一项正在进行的关于更年期和衰老的多地点纵向研究。在研究开始时（1995 - 1997年），女性报告了近期月经规律和经前症状的信息，以及社会人口统计学、症状、健康、睡眠、心理社会和生活方式等变量。围绝经期早期女性中持续性情绪症状的发生率（14.9% - 18.4%）高于绝经前女性（8% - 12%）。在对主要协变量和混杂因素进行调整的分析中，围绝经期早期女性出现易怒、紧张和频繁情绪变化的几率更高，但“情绪低落”的几率没有增加。围绝经期早期对整体烦躁情绪的影响在教育水平低于高中毕业的女性中最为明显。这些发现表明，持续性情绪症状和整体烦躁情绪与围绝经期早期有关，尤其是在教育程度较低的女性中。
