月经周期相关抑郁症状及其日间波动——一项动态评估研究。
Menstrual cycle related depressive symptoms and their diurnal fluctuations - an ambulatory assessment study.
机构信息
Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Schwendenerstraße 27, Berlin, 14195, Germany.
Division of Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, Berlin, 14195, Germany.
出版信息
BMC Womens Health. 2024 Nov 18;24(1):611. doi: 10.1186/s12905-024-03438-9.
BACKGROUND
Reproductive mood disorders indicate that within-person variation in depressive symptoms across the menstrual cycle can be related to ovarian hormone changes. Until now, such cycle-related symptom changes have been measured once daily, even though depression research indicates systematic diurnal changes in symptoms. Further, previous research often focused on aggregated depression scores. This study examined whether three daily assessments of depressive symptoms follow similar trajectories across the menstrual cycle and investigated within-person cyclical fluctuation of all individual symptoms and the aggregated score.
METHODS
77 naturally-cycling participants (35 with and 42 without depressive disorder) provided three daily ratings of depressive symptoms across one menstrual cycle to evaluate individual and summarized symptoms.
RESULTS
Reliability estimates (w) of the three diurnal measurements ranged from 0.56 to 0.78. Cyclicity showed statistically significant interindividual differences for all symptoms, and individual symptoms differed significantly from each other in their magnitude of cyclicity.
LIMITATIONS
Only one menstrual cycle was assessed to reduce participant burden. Further, ovulation testing dates were based on self-reported cycle lengths, and only LH (luteinizing hormone) peaks were tested without subsequent progesterone rises.
CONCLUSIONS
The results highlight the need for a symptom-specific approach to assess individual variance in cyclicity of depressive symptoms. Reliability for one daily assessment can be improved by using the afternoon value, a sum score for depressiveness, or multiple items per symptom. Furthermore, this study emphasizes, that depressive symptoms can systematically change across the menstrual cycle, and it is, therefore, important to include it in depression research. Exploring female-specific risk factors of depression will enable the development of person-tailored treatments.
TRIAL REGISTRATION
The study was preregistered at ClinicalTrials.gov (NCT04086316) with the first registration on 27/08/2019.
背景
生殖情绪障碍表明，个体在月经周期内的抑郁症状变化可能与卵巢激素变化有关。到目前为止，这种与周期相关的症状变化是每天测量一次，尽管抑郁研究表明症状存在系统的昼夜变化。此外，之前的研究通常集中在综合抑郁评分上。本研究旨在探讨每日三次评估抑郁症状是否在整个月经周期内遵循相似的轨迹，并研究个体症状和综合评分的周期性波动。
方法
77 名自然循环参与者（35 名患有和 42 名未患有抑郁障碍）在一个月经周期内每天三次评估抑郁症状，以评估个体和综合症状。
结果
日间三次测量的可靠性估计值（w）范围为 0.56 至 0.78。所有症状的周期性均表现出统计学上显著的个体间差异，并且个体症状在周期性波动幅度上彼此存在显著差异。
局限性
为了减轻参与者的负担，仅评估了一个月经周期。此外，排卵测试日期基于自我报告的周期长度，仅测试了 LH（黄体生成素）峰值，而没有随后的孕激素升高。
结论
研究结果强调需要采用特定症状的方法来评估抑郁症状周期性变化的个体差异。通过使用下午值、抑郁综合评分或每个症状的多个项目，可提高每日一次评估的可靠性。此外，本研究强调，抑郁症状可以在月经周期内系统地变化，因此在抑郁研究中纳入这一因素非常重要。探索女性特有的抑郁风险因素将有助于开发个性化治疗方法。
试验注册
该研究在 ClinicalTrials.gov 上进行了预先注册（NCT04086316），首次注册于 2019 年 8 月 27 日。
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