Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.
Department of Medical Sciences, Graduate School of Ajou University, Suwon, South Korea.
Eur Psychiatry. 2023 Sep 12;66(1):e80. doi: 10.1192/j.eurpsy.2023.2439.
The menopause transition is a vulnerable period that can be associated with changes in mood and cognition. The present study aimed to investigate whether a symptomatic menopausal transition increases the risks of depression, anxiety, and sleep disorders.
This population-based, retrospective cohort study analysed data from five electronic health record databases in South Korea. Women aged 45-64 years with and without symptomatic menopausal transition were matched 1:1 using propensity-score matching. Subgroup analyses were conducted according to age and use of hormone replacement therapy (HRT). A primary analysis of 5-year follow-up data was conducted, and an intention-to-treat analysis was performed to identify different risk windows over 5 or 10 years. The primary outcome was first-time diagnosis of depression, anxiety, and sleep disorder. We used Cox proportional hazard models and a meta-analysis to calculate the summary hazard ratio (HR) estimates across the databases.
Propensity-score matching resulted in a sample of 17,098 women. Summary HRs for depression (2.10; 95% confidence interval [CI] 1.63-2.71), anxiety (1.64; 95% CI 1.01-2.66), and sleep disorders (1.47; 95% CI 1.16-1.88) were higher in the symptomatic menopausal transition group. In the subgroup analysis, the use of HRT was associated with an increased risk of depression (2.21; 95% CI 1.07-4.55) and sleep disorders (2.51; 95% CI 1.25-5.04) when compared with non-use of HRT.
Our findings suggest that women with symptomatic menopausal transition exhibit an increased risk of developing depression, anxiety, and sleep disorders. Therefore, women experiencing a symptomatic menopausal transition should be monitored closely so that interventions can be applied early.
更年期过渡是一个脆弱的时期，可能与情绪和认知变化有关。本研究旨在探讨有症状的更年期过渡是否会增加抑郁、焦虑和睡眠障碍的风险。
本基于人群的回顾性队列研究分析了来自韩国五个电子健康记录数据库的数据。将有和无有症状更年期过渡的 45-64 岁女性按倾向评分匹配 1:1 进行匹配。根据年龄和激素替代疗法（HRT）的使用情况进行亚组分析。对 5 年随访数据进行了主要分析，并进行了意向治疗分析，以确定 5 年或 10 年内不同的风险窗口。主要结局是首次诊断为抑郁、焦虑和睡眠障碍。我们使用 Cox 比例风险模型和荟萃分析来计算数据库之间的综合危害比（HR）估计值。
倾向评分匹配产生了 17098 名女性的样本。有症状更年期过渡组的抑郁（2.10；95%置信区间[CI] 1.63-2.71）、焦虑（1.64；95%CI 1.01-2.66）和睡眠障碍（1.47；95%CI 1.16-1.88）的综合 HR 更高。在亚组分析中，与不使用 HRT 相比，使用 HRT 与抑郁（2.21；95%CI 1.07-4.55）和睡眠障碍（2.51；95%CI 1.25-5.04）的风险增加相关。
我们的研究结果表明，有症状更年期过渡的女性发生抑郁、焦虑和睡眠障碍的风险增加。因此，应密切监测有症状更年期过渡的女性，以便及早应用干预措施。
