Ðoković Danijela D, Jović Jelena J, Ðoković Jelena D, Knežević Marinela Ž, Djukić-Dejanović Slavica, Ristić-Ignjatović Dragana I
School of Medicine, University of Kragujevac; Psychiatric Clinic, Clinical Center Kragujevac Kragujevac, Serbia.
Department of Preventive Medicine, University of Prishtina-Kosovska Mitrovica, Kosovska Mitrovica, Serbia.
Med Glas (Zenica). 2015 Feb;12(1):79-85.
To assess the effect of hormone replacement therapy on postoperative depression and anxiety symptoms.
In observational prospective study 80 women divided into two groups were evaluated: women who received estrogen and androgen replacement therapy after hysterectomy with bilateral oophorectomy before onset of menopause (35-45 years old) and a control group that consisted of perimenipausal women (45-55 years old). Hormone replacement therapy began one week after surgery. The severity of depression and anxiety was evaluated through the use of Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. Subjects from the study group were interviewed right after the surgical treatment, one, two and three months later. Subjects from the control group were interviewed only once.
The women who underwent surgery had a statistically significantly higher score in Hamilton Depression Scale (p les than 0.001) and Hamilton Anxiety Scale (p=0.002) compared to the control perimenopausal women. There was a significant reduction of depressive and anxiety symptoms during hormone replacement therapy. Statistically significant difference in depressive score was found immediately after one month of hormone replacement therapy (first week/one month later: p=0.0057). Statistically significant difference in anxiety score appeared three months after the introduction of hormone therapy (first week/one month later: p=0.309; first week/two months later: p=0.046; first week/three months later: p les than 0.001). Level of serum luteinizing hormone was in correlation with depressive and anxiety score.
Estrogen-androgen replacement therapy may reduce the risk of psychiatric disorders developing in women with bilateral oophorectomy (indication for hysterectomy with oophorectomy was leiomyomata uteri).
评估激素替代疗法对术后抑郁和焦虑症状的影响。
在一项观察性前瞻性研究中，对80名女性进行了评估，她们被分为两组：在绝经前（35 - 45岁）行子宫切除加双侧卵巢切除术后接受雌激素和雄激素替代疗法的女性，以及由围绝经期女性（45 - 55岁）组成的对照组。激素替代疗法在手术后一周开始。通过使用汉密尔顿抑郁量表和汉密尔顿焦虑量表评估抑郁和焦虑的严重程度。研究组的受试者在手术治疗后、术后1个月、2个月和3个月接受访谈。对照组的受试者仅接受一次访谈。
与围绝经期对照女性相比，接受手术的女性在汉密尔顿抑郁量表（p小于0.001）和汉密尔顿焦虑量表（p = 0.002）上的得分在统计学上显著更高。在激素替代疗法期间，抑郁和焦虑症状有显著减轻。在激素替代疗法1个月后立即发现抑郁评分有统计学显著差异（第一周/1个月后：p = 0.0057）。在引入激素治疗3个月后出现焦虑评分的统计学显著差异（第一周/1个月后：p = 0.309；第一周/2个月后：p = 0.046；第一周/3个月后：p小于0.001）。血清促黄体生成素水平与抑郁和焦虑评分相关。
雌激素 - 雄激素替代疗法可能降低双侧卵巢切除女性（子宫切除加卵巢切除的指征为子宫肌瘤）发生精神障碍的风险。
