Arnold Amanda R, Prochaska Trinidi, Fickenwirth Maximilian, Powers Abigail, Smith Alicia K, Chahine E Britton, Stevens Jennifer S, Michopoulos Vasiliki
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States.
J Mood Anxiety Disord. 2024 Dec;8. doi: 10.1016/j.xjmad.2024.100082. Epub 2024 Aug 29.
Natural variation in ovarian steroid hormones across the female lifespan contributes to an increased risk for depressive and posttraumatic stress disorder (PTSD) symptoms in women. However, minimal work has focused on understanding the impacts of reproductive aging on the brain and behavioral health of trauma-exposed women. This systematic review examines the bidirectional relationship between trauma-related psychopathology and reproductive aging.
Following PRISMA guidelines, a systematic review of PubMed, PsychInfo, and Medline databases was undertaken to identify controlled studies on how trauma history impacts psychopathology and menopause symptoms during reproductive aging.
Twenty-one studies met the eligibility criteria, with only four utilizing the gold standard STRAW+ 10 criteria for defining reproductive aging stages. The peri and postmenopausal periods appear to be particularly vulnerable phases for individuals with trauma exposure. Menopause symptoms and trauma-related psychopathology symptom severity increase during reproductive aging with increases in the degree of trauma exposure. However, mechanistic insights that may explain this interaction are currently neglected in this area of research.
There is a significant lack of understanding regarding how reproductive aging and its related neuroendocrine changes impact the brain to influence PTSD and depression symptoms related to trauma exposure. This lack of basic understanding impedes the ability to identify, assess, and treat PTSD and depressive symptoms in trauma-exposed women most effectively, and mitigate the long-term consequences of these behavioral health symptoms on morbidity and mortality in aging women.
女性一生中卵巢甾体激素的自然变化会增加女性出现抑郁和创伤后应激障碍（PTSD）症状的风险。然而，很少有研究关注生殖衰老对受过创伤女性的大脑和行为健康的影响。本系统评价探讨创伤相关精神病理学与生殖衰老之间的双向关系。
按照PRISMA指南，对PubMed、PsychInfo和Medline数据库进行系统评价，以确定关于创伤史如何影响生殖衰老期间精神病理学和更年期症状的对照研究。
21项研究符合纳入标准，其中只有4项采用了定义生殖衰老阶段的金标准STRAW+10标准。围绝经期和绝经后期似乎是受过创伤个体特别脆弱的时期。在生殖衰老过程中，随着创伤暴露程度的增加，更年期症状和创伤相关精神病理学症状的严重程度也会增加。然而，目前该研究领域忽略了可能解释这种相互作用的机制性见解。
对于生殖衰老及其相关神经内分泌变化如何影响大脑，进而影响与创伤暴露相关的PTSD和抑郁症状，我们仍知之甚少。这种基本认识的缺乏阻碍了我们最有效地识别、评估和治疗受过创伤女性的PTSD和抑郁症状，并减轻这些行为健康症状对老年女性发病率和死亡率的长期影响。
