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45 至 64 岁女性使用加拿大老龄化纵向研究基线数据的抑郁、激素治疗与更年期过渡。

Depression, hormone therapy, and the menopausal transition among women aged 45 to 64 years using Canadian Longitudinal Study on aging baseline data.

机构信息

Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.

Department of Obstetrics and Gynecology, St. Joseph's Healthcare, Hamilton, Ontario, Canada.

出版信息

Menopause. 2020 Jul;27(7):763-770. doi: 10.1097/GME.0000000000001540.

Abstract

OBJECTIVE

To investigate the association between menopausal status, hormone therapy (HT) use and the presence of depressive symptoms among middle-aged women in Canada.

METHODS

Cross-sectional baseline data from 13,216 women aged 45 to 64 years from the Canadian Longitudinal Study on Aging (CLSA) was used. The association between menopausal status (pre- vs postmenopausal) and self-reported symptoms of depression based on a score of 10 or more on the Center for Epidemiologic Studies Short Depression Scale-10 was assessed using logistic regression. Use and duration of use of HT, time since menopause, age at onset of menopause, and socioeconomic status and other contextual variables were explored for the association with depression.

RESULTS

Overall, 18.4% of middle-aged women in the CLSA data were identified as depressed using the Center for Epidemiologic Studies Short Depression Scale-10. Based on the logistic regression models, women reporting premature menopause (before the age of 40 years) and postmenopausal women currently using HT had 1.45 (1.07-1.97) and 1.21 (1.02-1.44) greater odds of having depression. Chi-square analyses showed that women with depressive symptoms were more likely to have low education, low household incomes, live alone, be nulliparous, and have low social support.

CONCLUSIONS

Our findings highlight the association between depression and premature menopause among midlife women. Current HT use may be a proxy for more severe menopausal vasomotor symptoms, a known risk factor for depressive symptoms. Identification of risk factors, including social determinants of health, age at menopause, and menopausal symptoms can help guide clinicians when assessing mental health. : Video Summary:http://links.lww.com/MENO/A576.

摘要

目的

调查加拿大中年女性的绝经状态、激素治疗(HT)使用与抑郁症状之间的关系。

方法

使用加拿大老龄化纵向研究(CLSA)中 13216 名年龄在 45 至 64 岁的女性的横断面基线数据。使用逻辑回归评估绝经状态(绝经前与绝经后)与基于流行病学研究中心短抑郁量表-10 评分 10 或以上的自我报告抑郁症状之间的关联。探讨 HT 的使用和使用时间、绝经时间、绝经年龄、社会经济地位和其他背景变量与抑郁的关系。

结果

总体而言,CLSA 数据中有 18.4%的中年女性被确定为患有抑郁,使用流行病学研究中心短抑郁量表-10。基于逻辑回归模型,报告提前绝经(40 岁之前)和绝经后正在使用 HT 的女性发生抑郁的几率分别为 1.45(1.07-1.97)和 1.21(1.02-1.44)。卡方分析显示,有抑郁症状的女性更有可能受教育程度低、家庭收入低、独居、未婚和社会支持低。

结论

我们的研究结果强调了中年女性抑郁与提前绝经之间的关系。当前 HT 的使用可能是绝经后血管舒缩症状更严重的标志,这是抑郁症状的一个已知危险因素。确定包括健康的社会决定因素、绝经年龄和绝经症状在内的风险因素可以帮助临床医生评估心理健康。

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