Dennerstein Lorraine, Guthrie Janet R, Clark Margaret, Lehert Philippe, Henderson Victor W
Office for Gender and Health, Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
Menopause. 2004 Sep-Oct;11(5):563-8. doi: 10.1097/01.gme.0000113844.74462.f6.
There has been controversy about the relationship between menopause and depression. This study utilizes a unique prospective population-based data set of middle-aged, Australian-born women to identify determinants of depressed mood.
The Melbourne Women's Midlife Health Project sample consisted of 438 women aged 45 to 55 at baseline; they were followed annually for 11 years. Of this group, 314 (72%) completed the Center for Epidemiologic Studies Depression Scale (CES-D) scale in year 11 to measure depressed mood. Variables measured at baseline and annually included negative mood (measured with Affectometer) and psychosocial, hormonal, health, and lifestyle factors.
Women who had the highest CES-D scores were those who by year 11 were still in the menopause transition stage (had not reached final menstrual period) or had experienced surgical menopause. CES-D correlated with negative mood measured concurrently (r = 0.63) and baseline negative mood (r = 0.37). There was a significant reduction in negative mood for all menopause status groups, but those who experienced surgical menopause showed less reduction than other women. Ever-use or number of years of use of hormone therapy made no difference to CES-D outcome. CES-D was associated with baseline negative attitudes toward aging, mood, and premenstrual complaint experience and annual mood, poor self-rated health, number of bothersome symptoms, and daily hassles.
Women most likely to have higher depressed mood in the age group 57 to 67 are those who have undergone surgical menopause or have menstruated within the last 12 months. Prior negative mood, history of premenstrual complaints, negative attitudes toward aging or menopause, poor health, and daily hassles predict depressed mood.
绝经与抑郁症之间的关系一直存在争议。本研究利用一个独特的基于澳大利亚出生的中年女性人群的前瞻性数据集,来确定抑郁情绪的决定因素。
墨尔本女性中年健康项目样本在基线时由438名年龄在45至55岁之间的女性组成;她们被随访了11年。在这个群体中,314名(72%)女性在第11年完成了流行病学研究中心抑郁量表(CES-D)以测量抑郁情绪。在基线和每年测量的变量包括负面情绪(用情感量表测量)以及心理社会、激素、健康和生活方式因素。
CES-D得分最高的女性是那些到第11年仍处于绝经过渡阶段(未达到最终月经期)或经历过手术绝经的女性。CES-D与同时测量的负面情绪(r = 0.63)和基线负面情绪(r = 0.37)相关。所有绝经状态组的负面情绪都有显著降低,但经历手术绝经的女性比其他女性降低得少。激素疗法的曾经使用情况或使用年限对CES-D结果没有影响。CES-D与对衰老、情绪和经前不适经历的基线负面态度以及年度情绪、自我健康评价差、困扰症状数量和日常烦恼有关。
在57至67岁年龄组中,最有可能有较高抑郁情绪的女性是那些经历过手术绝经或在过去12个月内有过月经的女性。既往负面情绪、经前不适病史、对衰老或绝经的负面态度、健康状况差和日常烦恼可预测抑郁情绪。