Terauchi Masakazu, Hiramitsu Shiro, Akiyoshi Mihoko, Owa Yoko, Kato Kiyoko, Obayashi Satoshi, Matsushima Eisuke, Kubota Toshiro
Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan.
J Obstet Gynaecol Res. 2013 May;39(5):1007-13. doi: 10.1111/j.1447-0756.2012.02064.x. Epub 2013 Feb 4.
The aim of this study was to investigate the associations among depression, anxiety and physical symptoms in peri- and postmenopausal women in a clinical setting.
Two hundred and thirty-seven peri- and postmenopausal women enrolled in the Systematic Health and Nutrition Education Program at the Menopause Clinic of the Tokyo Medical and Dental University Hospital. Their responses to the Menopausal Health-Related Quality of Life (MHR-QOL) and Hospital Anxiety and Depression Scale (HADS) questionnaires were subjected to a cross-sectional analysis. The study focused on the relationship between the scores for HADS depression (HADS-D) and anxiety (HADS-A) subscales and those for somatic (nausea, dizziness, numbness, muscle and joint pains, tiredness, headaches), urinary (frequent urination), and vasomotor symptoms (hot flashes, night sweats) in the MHR-QOL questionnaire.
The correlations among the scores for the six somatic symptoms and HADS-D and HADS-A were stronger than those for urinary or vasomotor symptoms. Multiple logistic regression analysis revealed that the score for headaches and that for HADS-A were significantly associated with severe depression after adjustment (odds ratio (OR) [95% confidence interval (CI)]: 1.49 [1.06-2.10] and 1.58 [1.37-1.83], respectively), whereas the scores for nausea and numbness, as well as HADS-D, were significantly associated with severe anxiety (OR [95% CI]: 1.65 [1.15-2.39], 1.39 [1.05-1.84], and 1.36 [1.23-1.50], respectively).
Headaches were associated with depression, whereas nausea and numbness were associated with anxiety in peri- and postmenopausal women. The assessment of underlying mood disorders is required for the management of middle-aged women presenting with these somatic symptoms.
本研究旨在调查临床环境中围绝经期和绝经后女性抑郁、焦虑与躯体症状之间的关联。
237名围绝经期和绝经后女性参加了东京医科齿科大学医院更年期诊所的系统健康与营养教育项目。她们对更年期健康相关生活质量(MHR-QOL)问卷和医院焦虑抑郁量表(HADS)问卷的回答进行了横断面分析。该研究重点关注HADS抑郁(HADS-D)和焦虑(HADS-A)分量表得分与MHR-QOL问卷中躯体(恶心、头晕、麻木、肌肉和关节疼痛、疲劳、头痛)、泌尿(尿频)和血管舒缩症状(潮热、盗汗)得分之间的关系。
六种躯体症状得分与HADS-D和HADS-A之间的相关性强于泌尿或血管舒缩症状得分。多因素逻辑回归分析显示,调整后头痛得分和HADS-A得分与重度抑郁显著相关(优势比(OR)[95%置信区间(CI)]:分别为1.49[1.06-2.10]和1.58[1.37-1.83]),而恶心和麻木得分以及HADS-D得分与重度焦虑显著相关(OR[95%CI]:分别为1.65[1.15-2.39]、1.39[1.05-1.84]和1.36[1.23-1.50])。
围绝经期和绝经后女性中,头痛与抑郁相关,而恶心和麻木与焦虑相关。对于出现这些躯体症状的中年女性,需要评估其潜在的情绪障碍以进行管理。