Tatebayashi Yoshitaka
Mood Disorder Research Team, Depression Project, Tokyo Institute of Psychiatry.
Nihon Rinsho. 2007 Sep;65(9):1694-701.
This article reviews recent evidence related to perimenopausal and late life depression. Transition to menopause and its changing hormonal milieu are associated with higher risk for mood disorders in some women. Several randomized placebo-controlled trials reveal the antidepressant efficacy of the hormone replacement therapy in depressed perimenopausal women but caution is still required for its use on perimenopausal depression due to the side effects. In the elderly populations, both major and minor depressions are frequent and their natural histories in the community are poor. From the public health perspective of Japan where aging is progressing most rapidly among the world, depression prevention may be imperative, but requires accurate assessment of not only depression but also vascular, Alzheimer dementia and suicide in the elderly.
本文综述了与围绝经期及老年期抑郁症相关的最新证据。向更年期过渡及其不断变化的激素环境与部分女性患情绪障碍的较高风险相关。几项随机安慰剂对照试验揭示了激素替代疗法对围绝经期抑郁症女性的抗抑郁疗效，但由于存在副作用，在围绝经期抑郁症治疗中使用该疗法仍需谨慎。在老年人群中，重度和轻度抑郁症都很常见，且它们在社区中的自然病程不佳。从老龄化在世界上进展最快的日本的公共卫生角度来看，抑郁症预防可能势在必行，但不仅需要对抑郁症进行准确评估，还需要对老年人的血管疾病、阿尔茨海默病性痴呆和自杀情况进行准确评估。
