Tang R Y, Luo M, Fan Y B, Xie Z L, Huang F L, Zhang D D, Liu G F, Wang Y P, Lin S Q, Chen R
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing 100730, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Zhonghua Fu Chan Ke Za Zhi. 2022 Jun 25;57(6):419-425. doi: 10.3760/cma.j.cn112141-20220208-00064.
To determine the effects of menopausal stage, age and other associated risk factors on symptoms of anxiety and depression among women in a community in Beijing. This study was a community-based prospective cohort. Participants who had transitioned through natural menopause, completed two or more depressive and anxiety symptoms evaluations, aged 35 to 64 years, and did not use hormone therapy were selected from the Peking Union Medical College Hospital aging longitudinal cohort of women in midlife to this analysis. The primary outcome variables were depressive and anxiety symptoms, assessed by hospital anxiety and depression scale (HADS). The generalized estimation equation was used in the statistical analysis. Followed up from 2006 to 2014, 430 women and 2 533 HADS assessments were retained in the cohort. Depressive symptoms were more common than anxiety symptoms during all menopausal stages. The incidences of depressive and anxiety symptoms were 14.5% (19/191) and 3.1% (4/191) in the premenopausal -3 stage, respectively. The incidence increased in both menopausal transition and postmenopausal stage, with the highest incidence in the +1c stage [20.6% (155/751) and 8.8% (66/751), respectively]. However, these differences were not statistically significant (all >0.05). Depressive symptoms were highest in the ≥60-<65 age group [20.8% (74/355)], and anxiety symptoms were highest in the ≥50-<55 age group [8.2% (62/754)]; but there were no statistical significances between different age groups and depressive and anxiety symptoms (all >0.05). Multivariable analysis showed that high body mass index, low education status, and poor health status were independently associated with depressive symptoms (all <0.05), and that poor health status, trouble falling asleep, and early awakening were independently associated with anxiety symptoms (all <0.01). Depressive and anxiety symptoms are more common during menopausal transition and postmenopausal stage compared with reproductive stage. Depressive symptoms are more common than anxiety symptoms. To screen and assess depressive and anxiety symptoms in perimenopausal women is essential, especially for women with high risk factors.
为确定绝经阶段、年龄及其他相关危险因素对北京某社区女性焦虑和抑郁症状的影响。本研究为基于社区的前瞻性队列研究。从北京协和医院中年女性衰老纵向队列中选取自然绝经、完成两项或以上抑郁和焦虑症状评估、年龄在35至64岁且未使用激素治疗的参与者进行本分析。主要结局变量为抑郁和焦虑症状,采用医院焦虑抑郁量表(HADS)进行评估。统计分析采用广义估计方程。随访时间为2006年至2014年,队列中保留了430名女性及2533次HADS评估。在所有绝经阶段,抑郁症状均比焦虑症状更为常见。绝经前-3阶段抑郁和焦虑症状的发生率分别为14.5%(19/191)和3.1%(4/191)。在绝经过渡期和绝经后期发生率均有所增加,在+1c阶段发生率最高[分别为20.6%(155/751)和8.8%(66/751)]。然而,这些差异无统计学意义(均>0.05)。抑郁症状在≥60-<65岁年龄组最高[20.8%(74/355)],焦虑症状在≥50-<55岁年龄组最高[8.2%(62/754)];但不同年龄组与抑郁和焦虑症状之间无统计学意义(均>0.05)。多变量分析显示,高体重指数、低教育水平和健康状况差与抑郁症状独立相关(均<0.05),健康状况差、入睡困难和早醒与焦虑症状独立相关(均<0.01)。与生殖期相比,抑郁和焦虑症状在绝经过渡期和绝经后期更为常见。抑郁症状比焦虑症状更为常见。筛查和评估围绝经期女性的抑郁和焦虑症状至关重要,尤其是对于具有高风险因素的女性。