Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea.
Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul, South Korea.
J Psychiatr Res. 2022 Sep;153:82-89. doi: 10.1016/j.jpsychires.2022.06.051. Epub 2022 Jun 30.
Changes in the levels of female sex hormones are associated with mood disorders in middle-aged women. This study investigated the association between female reproductive factors and the development of newly diagnosed bipolar disorder (BD). We used a South Korean nationwide medical records database. Postmenopausal women aged 40 or older who underwent health examinations were identified and followed for the occurrence of BD. We identified female reproductive factors including the age at menarche and menopause, parity, history of breastfeeding, oral contraceptive (OC) use, and hormone therapy (HT), and investigated their association with the occurrence of newly diagnosed BD. During an average of 8.32 years (SD 0.83) of follow-up, the incidence of BD was 0.50 per 1000 person-years in postmenopausal women. Compared to women with menopause at an age of 40 years or younger, those with menopause at an age of 45 years or older showed decreased risks of BD. Compared to women who had never breastfed, those who had breastfed for more than 12 months showed a decreased risk of BD. Compared to women who never received HT, those who received HT showed an increased risk of BD in a time-dependent manner. Among postmenopausal women, later menopause and breastfeeding for more than one year were associated with a decreased risk of BD occurrence, and receiving HT was associated with an increased risk.
女性性激素水平的变化与中年女性的情绪障碍有关。本研究调查了女性生殖因素与新诊断的双相情感障碍（BD）发展之间的关系。我们使用了韩国全国性的医疗记录数据库。确定了年龄在 40 岁或以上、接受健康检查的绝经后妇女，并对其发生 BD 的情况进行了随访。我们确定了女性生殖因素，包括初潮和绝经年龄、生育次数、母乳喂养史、口服避孕药（OC）使用情况和激素治疗（HT），并调查了它们与新诊断的 BD 发生之间的关系。在平均 8.32 年（SD 0.83）的随访期间，绝经后妇女的 BD 发病率为每 1000 人年 0.50 例。与 40 岁或以下绝经的女性相比，45 岁或以上绝经的女性发生 BD 的风险降低。与从未母乳喂养的女性相比，母乳喂养超过 12 个月的女性发生 BD 的风险降低。与从未接受 HT 的女性相比，HT 的女性在时间依赖性的基础上增加了 BD 的风险。在绝经后妇女中，较晚的绝经和超过一年的母乳喂养与 BD 发生风险降低有关，而 HT 的使用与风险增加有关。
