Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
Epidemiol Psychiatr Sci. 2022 Aug 26;31:e60. doi: 10.1017/S2045796022000439.
There has been increasing evidence of hormonal changes during reproductive events that lead to mood changes. However, studies on the severity of psychological problems according to the menopausal stage are limited. Thus, this study aimed to investigate the association between menopausal stages, depression and suicidality.
A total of 45 177 women who underwent regular health check-ups between 2015 and 2018 at Kangbuk Samsung Hospital were included. Participants were stratified into four groups (pre-menopause, early transition, late transition and post-menopause) based on the Stages of Reproductive Aging Workshop Criteria. The Center for Epidemiological Studies-Depression scale (CESD) was used to evaluate depressive symptoms, and the degree of depressive symptoms was classified as moderate (CESD score 16-24) or severe (CESD score ⩾ 25). To measure suicide risk, we administered questionnaires related to suicidal ideation.
Overall, the prevalence of CESD scores of 16-24 and ⩾ 25 was 7.6 and 2.8%, respectively. Menopausal stages were positively associated with depressive symptoms in a dose-dependent manner. Multivariable-adjusted prevalence ratios (PRs, 95% confidence intervals) for CESD scores of 16-24 comparing the stages of the early menopausal transition (MT), late MT and post-menopause to pre-menopause was 1.28 (1.16-1.42), 1.21 (1.05-1.38) and 1.58 (1.36-1.84), respectively. The multivariable-adjusted PRs for CESD scores ⩾ 25 comparing the stages of the early MT, late MT and post-menopause to pre-menopause were 1.31 (1.11-1.55), 1.39 (1.12-1.72), 1.86 (1.47-2.37), respectively. In addition, the multivariable-adjusted PRs for suicidal ideation comparing the early MT, late MT and post-menopause stages to the pre-menopause stage were 1.24 (1.12-1.38), 1.07 (0.93-1.24) and 1.46 (1.25-1.70) ( for trend <0.001), respectively.
These findings indicate that the prevalence of depressive symptoms and suicidal ideation increases with advancing menopausal stage, even pre-menopause.
越来越多的证据表明，生殖事件期间的激素变化会导致情绪变化。然而，根据绝经期阶段研究心理问题严重程度的研究有限。因此，本研究旨在探讨绝经期阶段与抑郁和自杀意念之间的关系。
本研究共纳入了 2015 年至 2018 年期间在康伯斯三星医院进行定期健康检查的 45177 名女性。根据生殖衰老工作坊标准，参与者被分为四组（绝经前、早期过渡、晚期过渡和绝经后）。采用流行病学研究中心抑郁量表（CESD）评估抑郁症状，将抑郁症状严重程度分为中度（CESD 评分 16-24）或重度（CESD 评分 ⩾25）。为了测量自杀风险，我们使用了与自杀意念相关的问卷。
总体而言，CESD 评分 16-24 和 ⩾25 的患病率分别为 7.6%和 2.8%。绝经期阶段与抑郁症状呈剂量依赖性正相关。多变量调整后，与绝经前相比，早期绝经过渡（MT）、晚期 MT 和绝经后 CESD 评分 16-24 的患病率比（95%置信区间）分别为 1.28（1.16-1.42）、1.21（1.05-1.38）和 1.58（1.36-1.84）。多变量调整后，与绝经前相比，早期 MT、晚期 MT 和绝经后 CESD 评分 ⩾25 的患病率比分别为 1.31（1.11-1.55）、1.39（1.12-1.72）和 1.86（1.47-2.37）。此外，与绝经前相比，早期 MT、晚期 MT 和绝经后阶段自杀意念的多变量调整后患病率比分别为 1.24（1.12-1.38）、1.07（0.93-1.24）和 1.46（1.25-1.70）（趋势<0.001）。
这些发现表明，即使在绝经前，随着绝经期阶段的进展，抑郁症状和自杀意念的患病率也会增加。
