Blümel Juan Enrique M, Castelo-Branco Camil, Cancelo María J, Córdova Andrea T, Binfa Lorena E, Bonilla Hilda G, Muñoz Ingrid G, Vergara Vivian G, Sarrá Salvador C
Dpto. Medicina Sur, Facultad Medicina, Hospital Barros Luco-Trudeau, Universidad de Chile, Fundación PROSAM, Santiago de Chile, Chile.
Maturitas. 2004 Nov 15;49(3):205-10. doi: 10.1016/j.maturitas.2004.01.011.
It has been suggested that hormonal changes and environmental alterations during the climacteric period are important in the development of psychological symptoms.
To evaluate the role of biological and psycho-social factors in the prevalence of climacteric symptoms.
Open, cross-sectional, observational and descriptive study.
A total of 300 women between 40 and 59 years of age were evaluated using Greene scale for climacteric symptoms, Cooper questionnaire for psychosomatic symptoms of stress, Smilkstein family apgar for family dysfunction, Duke-UNC questionnaire for social support and Israel scale for vital events. All these tests have been previously validated in Spanish.
Postmenopausal women do not have higher prevalence of psychological symptoms, they only have more vasomotor symptoms. Premenopausal women with vasomotor symptoms have more psychological and somatic symptoms and stress, independently of the vital events, family dysfunction or poor social support. Vasomotor symptoms in the premenopause are associated with increased risk of anxiety (OR: 3.7, IC: 1.4-9.7; P<0.008), depression (OR: 8.1, IC: 2.5-26.4; P<0.0005), somatic symptoms (OR: 14.9, IC: 3.4-65.3; P<0.0003), sexual dysfunction (OR: 7.2, IC: 2.5-20.6; P<0.0002) and stress (OR: 7.5, IC: 3.5-15.9; P<0.0001). Negative vital events and family dysfunction increase in minor intensity the risk of anxiety, depression and stress.
In conclusion, psychological symptoms are frequent in the premenopause and are associated to vasomotor symptoms. This observation links psychological symptoms with menopausal transition and might suggest an organic base in their origin. The negative psycho-social environment is a factor that favours the development of these symptoms.
有人提出,更年期期间的激素变化和环境改变在心理症状的发生发展中起重要作用。
评估生物因素和心理社会因素在更年期症状患病率中的作用。
开放性、横断面、观察性和描述性研究。
使用格林更年期症状量表、库珀压力身心症状问卷、斯米尔斯坦家庭功能量表、杜克大学-北卡罗来纳大学社会支持问卷和以色列生活事件量表对300名40至59岁的女性进行评估。所有这些测试之前均已在西班牙语中得到验证。
绝经后女性心理症状的患病率并不更高,她们只是血管舒缩症状更多。有血管舒缩症状的绝经前女性有更多的心理和躯体症状以及压力,与生活事件、家庭功能障碍或社会支持不足无关。绝经前的血管舒缩症状与焦虑风险增加相关(比值比:3.7,可信区间:1.4-9.7;P<0.008)、抑郁(比值比:8.1,可信区间:2.5-26.4;P<0.0005)、躯体症状(比值比:14.9,可信区间:3.4-65.3;P<0.0003)、性功能障碍(比值比:7.2,可信区间:2.5-20.6;P<0.0002)和压力(比值比:7.5,可信区间:3.5-15.9;P<0.0001)。负面生活事件和家庭功能障碍会轻度增加焦虑、抑郁和压力的风险。
总之,心理症状在绝经前很常见,且与血管舒缩症状相关。这一观察结果将心理症状与绝经过渡联系起来,并可能暗示其起源有器质性基础。负面的心理社会环境是这些症状发展的一个促进因素。