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围绝经期/绝经后伴发焦虑抑郁障碍患者的更年期综合征症状:与躯体因素或心理障碍相关。

The symptomatology of climacteric syndrome: whether associated with the physical factors or psychological disorder in perimenopausal/postmenopausal patients with anxiety-depression disorder.

机构信息

Department of Neurology, The Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, China.

出版信息

Arch Gynecol Obstet. 2012 May;285(5):1345-52. doi: 10.1007/s00404-011-2151-z. Epub 2011 Nov 29.

Abstract

PURPOSE

To explore whether the symptoms of climacteric syndrome associated with its physical factors or psychological disorder in perimenopausal/postmenopausal patients with anxiety-depression disorder.

METHODS

We recruited 78 climacteric patients with anxiety-depression disorder and 72 control participants in perimenopausal/postmenopausal without anxiety-depression disorder for this study. We measured symptoms using the Greene Climacteric Symptom Scale in all cases. We also collected demographic data and tested sexual hormone, blood pressure, bone density, cognitive, estrogen receptor-alpha (ERα) gene polymorphism as physiological factors, using HARS-14 and CHDS assessed psychological disorder degree.

RESULTS

C-MMSE scores as well as Estradiol and progesterone levels in the anxiety-depression disorder group were significantly lower compared to the control group (P < 0.01). In addition, the anxiety-depression disorder group had significantly higher Greene Climacteric Scale scores, as well as somatic symptoms compared to controls (P < 0.01). Moreover, the anxiety, depression and somatic symptoms of the Greene Climacteric Scale were positively correlated with HARS-14 and CHDS scores (P < 0.001) and negatively with estrogen level and C-MMSE scores (P < 0.05) in the anxiety-depression disorder group. Greene Climacteric Scale Symptoms were not significantly correlated with blood pressure, bone density or other factors (P > 0.05). There was no significant change in the allele frequency or the estrogen receptor-alpha gene polymorphisms, between the two groups (P > 0.05); however, the Pp genotype was negatively associated with C-MMSE scores (r = appraises, P = 0.033).

LIMITATIONS

The sample size was relatively small.

CONCLUSIONS

The symptoms of somatic symptoms in patients with climacteric syndrome and anxiety-depression disorder are associated with the emotional disorder but not with a physical disease. The Pp ERα polymorphism Pvu II is associated with a cognitive decrease.

摘要

目的

探讨围绝经期/绝经后伴发焦虑-抑郁障碍的女性患者的更年期综合征症状是与躯体因素相关,还是与心理障碍相关。

方法

本研究共纳入 78 例伴发焦虑-抑郁障碍的更年期综合征患者和 72 例围绝经期/绝经后无焦虑-抑郁障碍的对照患者。所有患者均采用 Greene 更年期症状量表(Greene climacteric scale,GCS)评估症状。收集人口统计学数据及检测性激素、血压、骨密度、认知功能、雌激素受体-α(estrogen receptor-α,ERα)基因多态性等生理因素,采用汉密尔顿焦虑量表(Hamilton anxiety rating scale,HARS-14)和认知障碍抑郁量表(cognitive impairment depression scale,CHDS)评估心理障碍程度。

结果

与对照组相比,焦虑-抑郁障碍组患者的简易精神状态检查量表(mini-mental state examination,MMSE)评分以及雌二醇和孕酮水平显著降低(P<0.01)。此外,焦虑-抑郁障碍组患者的 GCS 评分以及躯体症状显著高于对照组(P<0.01)。而且,GCS 中的焦虑、抑郁和躯体症状与 HARS-14 和 CHDS 评分呈正相关(P<0.001),与雌激素水平和 MMSE 评分呈负相关(P<0.05)。在焦虑-抑郁障碍组中,GCS 症状与血压、骨密度或其他因素无显著相关性(P>0.05)。两组间 ERα 基因 Pvu II 多态性的等位基因频率或基因型无显著差异(P>0.05);然而,Pp 基因型与 MMSE 评分呈负相关(r=-0.25,P=0.033)。

局限性

样本量相对较小。

结论

伴发焦虑-抑郁障碍的更年期综合征患者的躯体症状与情绪障碍相关,而与躯体疾病无关。ERα 基因 Pvu II 多态性 Pp 与认知能力下降相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77dd/3325418/bb4121ea289d/404_2011_2151_Fig1_HTML.jpg

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