Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Epidemiology Department, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
J Affect Disord. 2024 Dec 15;367:426-433. doi: 10.1016/j.jad.2024.08.237. Epub 2024 Sep 2.
Women may be vulnerable to elevated depressive symptoms during the menopause transition (MT). Studies generally have not considered premenopausal depressive symptom history or examined symptoms in relation to the final menstrual period (FMP).
To identify specific time points in relation to the FMP when depressive symptoms increase or decrease.
Participants were 1582 multiracial/ethnic women from the longitudinal Study of Women's Health Across the Nation (SWAN). Biological, psychosocial, and depressive symptom data were collected approximately annually. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CESD) scale.
Women with high baseline depressive symptoms (CES-D ≥ 16) declined in symptoms (M = -1.04/yr., 95 % CI = -1.58, -0.50) until 4 years before the FMP, followed by a smaller decrease (M = -0.50/yr., 95 % CI = -0.72, -0.28) until 18 months after the FMP. Depressive symptoms increased (M = 0.21/yr., 95 % CI = 0.11, 0.30) in those with low baseline symptoms until 1 year before the FMP, and decreased (M = -0.06/yr., 95 % CI = -0.11, -0.008) going forward. Greater social support, higher levels of follicle stimulating hormone and estradiol, and less sleep disturbance contributed to greater decline in depressive symptoms among those with high baseline depressive symptoms. Anxiety, experiencing stressful life events, lower body mass index, and poor role-physical function contributed to an increase in depressive symptoms among those with low baseline symptoms.
Excluded women had higher baseline CES-D scores. Lacked pre-MT depression for pre/early perimenopausal women at baseline.
Accounting for baseline depressive symptom level and focusing on the FMP more precisely characterize depressive symptom change over the MT.
女性在更年期过渡期间（MT）可能容易出现抑郁症状升高。研究通常没有考虑到绝经前的抑郁症状史，也没有检查与最后一次月经（FMP）相关的症状。
确定与 FMP 相关的特定时间点，在此期间抑郁症状增加或减少。
参与者是来自纵向妇女健康全国研究（SWAN）的 1582 名多种族/族裔女性。大约每年收集一次生物、心理社会和抑郁症状数据。使用流行病学研究中心抑郁量表（CESD）量表测量抑郁症状。
基线时抑郁症状较高（CES-D≥16）的女性症状逐渐减轻（M=-1.04/年，95%置信区间=-1.58，-0.50），直到 FMP 前 4 年，随后下降幅度较小（M=-0.50/年，95%置信区间=-0.72，-0.28），直到 FMP 后 18 个月。基线时抑郁症状较低的女性抑郁症状增加（M=0.21/年，95%置信区间=0.11，0.30），直到 FMP 前 1 年，随后下降（M=-0.06/年，95%置信区间=-0.11，-0.008）。较高的社会支持、较高的卵泡刺激素和雌二醇水平以及较少的睡眠障碍有助于高基线抑郁症状女性的抑郁症状明显减轻。焦虑、经历压力生活事件、较低的体重指数和较差的身体角色功能导致低基线症状女性的抑郁症状增加。
排除的女性基线 CES-D 评分较高。缺乏基线时处于绝经前/早期绝经期女性的绝经前抑郁。
考虑到基线抑郁症状水平，并更精确地关注 FMP，可以更好地描述 MT 期间抑郁症状的变化。
