Hunter Myra, Battersby Rosie, Whitehead Malcolm
Department of Psychological Medicine, King's College Hospital and School of Medicine and Dentistry, London, UK.
Maturitas. 2008 Sep-Oct;61(1-2):95-106. doi: 10.1016/j.maturitas.2008.09.013.
The importance of distinguishing climacteric symptoms from other psychological and somatic complaints has been repeatedly stressed, but as yet no detailed guidelines are available to assist the clinician in the day-to-day management of patients. Previous epidemiological surveys of climacteric symptoms have been criticised because of inadequate methodology. We have attempted to overcome most of these problems and to provide a more detailed analysis of the relationships between menopausal status and psychological and somatic symptoms. Eight hundred and fifty pre-, peri- and post-menopausal women, aged 45-65 yr, took part in a cross-sectional survey of general health, psychosocial factors and current symptomatology. They were a non-menopause clinic sample and were blind to the purpose of the study. Using a principal components analysis, the relationships between symptoms were examined. Certain psychological and somatic symptoms occurred together in specific clusters. Some of these symptom clusters, e.g., vasomotor symptoms and sexual difficulties, were best predicted solely by menopausal status, while others, such as psychological and somatic symptoms, were more clearly associated with psychosocial factors. On the basis of these results, guidelines for the assessment of climacteric and post-menopausal women can be suggested.
区分更年期症状与其他心理和躯体不适的重要性已被反复强调，但目前尚无详细的指南可协助临床医生对患者进行日常管理。以往关于更年期症状的流行病学调查因方法不当而受到批评。我们试图克服这些问题中的大部分，并对绝经状态与心理和躯体症状之间的关系进行更详细的分析。850名年龄在45至65岁之间的绝经前、围绝经期和绝经后女性参与了一项关于总体健康、心理社会因素和当前症状的横断面调查。她们是一个非更年期诊所样本，对研究目的不知情。采用主成分分析法研究症状之间的关系。某些心理和躯体症状在特定的集群中同时出现。其中一些症状集群，如血管舒缩症状和性功能障碍，仅通过绝经状态就能得到最佳预测，而其他症状，如心理和躯体症状，则与心理社会因素更密切相关。基于这些结果，可以提出评估更年期和绝经后女性的指南。
