Woods Nancy Fugate, Smith-DiJulio Kathleen, Percival Donald B, Tao Eunice Y, Mariella Anne, Mitchell Sullivan
Department of Family and Child Nursing, University of Seattle, WA 98195-7260, USA.
Menopause. 2008 Mar-Apr;15(2):223-232. doi: 10.1097/gme.0b013e3181450fc2.
To characterize patterns of depressed mood during the menopausal transition (MT) in relation to age and MT-related factors and to assess the contribution of factors related to depressed mood at earlier points in the life span.
Women (N = 508) were recruited from 1990 to 1992 from multiethnic neighborhoods and followed annually through 2005: 302 met the eligibility criteria for analyses reported here. The Center for Epidemiologic Studies Depression scale (CES-D) and a menstrual calendar were completed annually throughout the study. A subset of women provided a first morning voided urine specimen from 1997 through 2005. Urine samples were assayed for estrone glucuronide, follicle-stimulating hormone, testosterone, and cortisol. Mixed effects modeling was used to identify changes in CES-D scores over time, including the relationship to age, MT-related factors, and factors related to depression at other points in the life span (postpartum depression/blues, life stress, or family history of clinical depression).
Age was modestly and negatively related to CES-D scores, but MT stage alone was not, except that the late MT stage was significantly related to depressed mood. Hot flash activity, life stress, family history of depression, history of "postpartum blues," sexual abuse history, body mass index, and use of antidepressants were also individually related to depressed mood; the hormonal assays and age of entry into and duration of late MT stage were unrelated.
Although women in the late MT stage are vulnerable to depressed mood, factors that account for depressed mood earlier in the life span continue to have an important influence and should be considered in studies of etiology and therapeutics.
描述绝经过渡（MT）期间抑郁情绪模式与年龄及MT相关因素的关系，并评估生命早期与抑郁情绪相关因素的作用。
1990年至1992年从多民族社区招募了女性（N = 508），并追踪至2005年，每年进行随访：302名符合此处报告分析的纳入标准。在整个研究过程中，每年完成流行病学研究中心抑郁量表（CES-D）和月经日历。一部分女性在1997年至2005年期间提供了首次晨尿样本。对尿液样本进行雌酮葡萄糖醛酸苷、促卵泡激素、睾酮和皮质醇检测。采用混合效应模型确定CES-D评分随时间的变化，包括与年龄、MT相关因素以及生命其他阶段（产后抑郁/情绪低落、生活压力或临床抑郁家族史）抑郁相关因素的关系。
年龄与CES-D评分呈轻度负相关，但单独的MT阶段并非如此，不过MT晚期与抑郁情绪显著相关。潮热活动、生活压力、抑郁家族史、“产后情绪低落”史、性虐待史、体重指数和抗抑郁药使用也分别与抑郁情绪相关；激素检测以及进入MT晚期的年龄和持续时间无关。
尽管处于MT晚期的女性易患抑郁情绪，但生命早期导致抑郁情绪的因素仍有重要影响，在病因学和治疗研究中应予以考虑。
