抑郁症家族史及绝经过渡在中年女性重度抑郁症发病中的作用：全国妇女健康心理健康研究（SWAN MHS）
The role of family history of depression and the menopausal transition in the development of major depression in midlife women: Study of women's health across the nation mental health study (SWAN MHS).
作者信息
Colvin Alicia, Richardson Gale A, Cyranowski Jill M, Youk Ada, Bromberger Joyce T
机构信息
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
出版信息
Depress Anxiety. 2017 Sep;34(9):826-835. doi: 10.1002/da.22651. Epub 2017 May 10.
BACKGROUND
This study evaluated whether family history of depression predicts major depression in midlife women above and beyond static risk factors (such as personal history of depression prior to midlife) and risks that may change dynamically across midlife (such as menopausal, psychosocial, and health profiles).
METHODS
Participants were 303 African American and Caucasian women (42-52 years at baseline) recruited into the Study of Women's Health across the Nation (SWAN) Mental Health Study (MHS) in Pittsburgh. Major depression was assessed annually with Structured Clinical Interviews for DSM-IV. Family mental health history was collected at the ninth or tenth annual follow-up. Random effects logistic regression was used to assess the relationship between family history of depression and midlife depression, controlling for baseline sociodemographic characteristics and time-varying risk factors.
RESULTS
Family history of depression was associated with midlife depression after adjusting for participant's history of major depression prior to midlife, trait anxiety and baseline age, and time-varying menopausal status, body mass index, very upsetting life events, and chronic difficulties (OR = 2.24, 95% CI = 1.17-4.29, P = .02). Higher odds of major depression were found when women were late perimenopausal or postmenopausal relative to when they were premenopausal or early perimenopausal (OR = 3.01, 95% CI = 1.76-5.15, P < .0001). However, menopausal status was only associated with major depression among women without a family history.
CONCLUSIONS
Family history of depression predicts major depression in midlife women independent of the menopausal transition and other time-varying covariates. Notably, the menopausal transition was associated with increased risk only among women without a family history of depression.
背景
本研究评估了抑郁症家族史是否能在静态风险因素（如中年之前的抑郁症个人史）以及可能在中年期间动态变化的风险因素（如更年期、心理社会和健康状况）之外，预测中年女性的重度抑郁症。
方法
参与者为303名非裔美国人和白人女性（基线年龄42 - 52岁），她们被招募进入匹兹堡的全国女性健康研究（SWAN）心理健康研究（MHS）。每年使用《精神疾病诊断与统计手册》第四版（DSM-IV）的结构化临床访谈来评估重度抑郁症。在第九次或第十次年度随访时收集家族心理健康史。使用随机效应逻辑回归来评估抑郁症家族史与中年抑郁症之间的关系，同时控制基线社会人口学特征和随时间变化的风险因素。
结果
在调整了参与者中年之前的重度抑郁症病史、特质焦虑和基线年龄，以及随时间变化的更年期状态、体重指数、非常令人苦恼的生活事件和慢性困难后，抑郁症家族史与中年抑郁症相关（比值比[OR] = 2.24，95%置信区间[CI] = 1.17 - 4.29，P = 0.02）。与绝经前或围绝经期早期相比，女性处于围绝经期晚期或绝经后期时患重度抑郁症的几率更高（OR = 3.01，95% CI = 1.76 - 5.15，P < 0.0001）。然而，更年期状态仅与无家族史的女性中的重度抑郁症相关。
结论
抑郁症家族史可独立于更年期过渡及其他随时间变化的协变量预测中年女性的重度抑郁症。值得注意的是，更年期过渡仅与无抑郁症家族史的女性中风险增加相关。
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