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Longitudinal change in reproductive hormones and depressive symptoms across the menopausal transition: results from the Study of Women's Health Across the Nation (SWAN).

作者信息

Bromberger Joyce T, Schott Laura L, Kravitz Howard M, Sowers Maryfran, Avis Nancy E, Gold Ellen B, Randolph John F, Matthews Karen A

机构信息

University of Pittsburgh, Pittsburgh, PA 15213, USA.

出版信息

Arch Gen Psychiatry. 2010 Jun;67(6):598-607. doi: 10.1001/archgenpsychiatry.2010.55.


DOI:10.1001/archgenpsychiatry.2010.55
PMID:20530009
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3129620/
Abstract

CONTEXT: The contribution of reproductive hormones to mood has been the focus of considerable research. Results from clinical and epidemiological studies have been inconsistent. It remains unclear whether alterations in serum hormone levels across the menopausal transition are linked to depressive symptoms. OBJECTIVES: To evaluate the relationship between serum hormone levels and high depressive symptoms and whether hormone levels or their change might explain the association of menopausal status with depressive symptoms previously reported in a national sample of midlife women. DESIGN: A longitudinal, community-based, multisite study of menopause. Data were collected at baseline and annually from December 1995 to January 2008 on a range of factors. Early follicular phase serum samples were assayed for levels of estradiol, follicle-stimulating hormone, testosterone, and dehydroepiandrosterone sulfate. SETTING: Seven communities nationwide. PARTICIPANTS: A community-based sample of 3302 multiethnic women, aged 42 to 52 years, still menstruating and not using exogenous reproductive hormones. Main Outcome Measure Depressive symptoms assessed with the Center for Epidemiological Studies Depression Scale (CES-D). The primary outcome was a CES-D score of 16 or higher. RESULTS: In multivariable random-effects logistic regression models, log-transformed testosterone level was significantly positively associated with higher odds of a CES-D score of 16 or higher (odds ratio = 1.15; 95% confidence interval, 1.01-1.31) across 8 years, and a larger increase in log-transformed testosterone from baseline to each annual visit was significantly associated with increased odds of a CES-D score of 16 or higher (odds ratio = 1.23; 95% confidence interval, 1.04-1.45). Less education, being Hispanic, and vasomotor symptoms, stressful life events, and low social support at each visit were each independently associated with a CES-D score of 16 or higher. No other hormones were associated with a CES-D score of 16 or higher. Being perimenopausal or postmenopausal compared with being premenopausal remained significantly associated with a CES-D score of 16 or higher in all analyses. CONCLUSIONS: Higher testosterone levels may contribute to higher depressive symptoms during the menopausal transition. This association is independent of menopausal status, which remains an independent predictor of higher depressive symptoms.

摘要

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本文引用的文献

[1]
Testosterone, sex hormone-binding globulin and free androgen index among adult women: chronological and ovarian aging.

Hum Reprod. 2009-9

[2]
A prospective study of the association between endogenous hormones and depressive symptoms in postmenopausal women.

Menopause. 2009

[3]
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[4]
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J Psychosom Res. 2007-9

[5]
Associations between sex steroid hormone levels and depressive symptoms in elderly men and women: results from the Health ABC study.

Psychoneuroendocrinology. 2007

[6]
Symptoms during the menopausal transition and early postmenopause and their relation to endocrine levels over time: observations from the Seattle Midlife Women's Health Study.

J Womens Health (Larchmt). 2007-6

[7]
Lower serum DHEAS levels are associated with a higher degree of physical disability and depressive symptoms in middle-aged to older African American women.

Maturitas. 2007-8-20

[8]
Depressive symptoms during the menopausal transition: the Study of Women's Health Across the Nation (SWAN).

J Affect Disord. 2007-11

[9]
Plasma testosterone and dehydroepiandrosterone sulfate in male and female patients with dysthymic disorder.

J Affect Disord. 2007-8

[10]
Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement.

J Clin Endocrinol Metab. 2007-2

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