School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, Yuhangtang Road 866, Hangzhou, 310058, Zhejiang, China.
School of Public Health, Wuhan University, Wuhan, Hubei, China.
Arch Womens Ment Health. 2023 Oct;26(5):697-705. doi: 10.1007/s00737-023-01354-9. Epub 2023 Aug 8.
The association between perimenopausal depression and many chronic conditions among women has been well-established. However, the role of depression during perimenopause in the progression of multiple chronic conditions (multimorbidity) remains poorly understood.
A total of 1,216 community-dwelling women in their perimenopause period between 2010 and 2016 were enrolled in our analysis, and followed up for the progression of multimorbidity. Depression, as well as its severity, was evaluated by the Center for Epidemiologic Studies Depression 10-item scale (CES-D-10). Progression of multimorbidity was defined as the first report of two or more chronic conditions for participants without multimorbidity or the new report of one or more conditions for those with multimorbidity. Univariable and multivariable Cox proportional hazards model and the restricted cubic spline regression model were performed to assess the prospective association between perimenopausal depression and the progression of multimorbidity.
A total of 480 (39.5%) women reported depression during perimenopause, and 529 (43.5%) women progressed to multimorbidity. After adjusting for socio-demographic and lifestyle factors, perimenopausal depression was independently associated with the progression of multimorbidity (hazard ratio [HR]: 1.34; 95% confidence interval [CI]: 1.13 to 1.60). Moreover, the severity of depression was positively and linearly associated with the progression of multimorbidity (P < 0.05).
Our finding reveals a prospective association between perimenopausal depression and the progression of multimorbidity, indicating interventions targeting perimenopausal depression may reduce the burden of chronic diseases and multimorbidity in women's post-menopausal life.
围绝经期抑郁与女性许多慢性疾病之间的关联已得到充分证实。然而，围绝经期抑郁在多种慢性疾病（多种共病）进展中的作用仍知之甚少。
我们共纳入了 2010 年至 2016 年间处于围绝经期的 1216 名社区女性，并对其多种共病的进展情况进行了随访。采用流行病学研究中心抑郁量表 10 项量表（CES-D-10）评估抑郁及其严重程度。多种共病的进展定义为无多种共病的参与者首次报告两种或两种以上慢性疾病，或有多种共病的参与者新报告一种或多种疾病。采用单变量和多变量 Cox 比例风险模型和限制三次样条回归模型评估围绝经期抑郁与多种共病进展之间的前瞻性关联。
共有 480 名（39.5%）女性报告围绝经期抑郁，529 名（43.5%）女性进展为多种共病。在校正社会人口学和生活方式因素后，围绝经期抑郁与多种共病的进展独立相关（风险比 [HR]：1.34；95%置信区间 [CI]：1.13 至 1.60）。此外，抑郁的严重程度与多种共病的进展呈正线性相关（P < 0.05）。
我们的研究结果揭示了围绝经期抑郁与多种共病进展之间的前瞻性关联，表明针对围绝经期抑郁的干预措施可能会减轻女性绝经后生活中慢性疾病和多种共病的负担。
