Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause - The Harvard Study of Moods and Cycles
Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause - The Harvard Study of Moods and Cycles
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DOI：
10.1001/archpsyc.60.1.29
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发表时间：
2003-01-01
影响因子：
--
通讯作者：
Cohen, LS
中科院分区：
文献类型：
--
作者：
Harlow, BL;Wise, LA;Cohen, LS
背景资料：很少有研究确定的影响，一生中的抑郁症的早期过渡到menopaus.Methods：生殖和精神访谈和早期卵泡阶段的血液标本，在研究招募和每6个月在36个月的随访期间，从332名妇女和644名妇女没有抑郁症的历史，36至45岁。我们使用月经周期标志物来确定围绝经期的开始，围绝经期的定义是从研究入组到随访的时间：（1）月经周期长度变化7天或更长;（2）月经量或持续时间的变化;或（3）闭经持续至少3个月。有抑郁症病史的妇女围绝经期发病率是无抑郁症病史妇女的1.2倍（95%置信区间，0.9-1.6）。与非抑郁症女性相比，研究入组时有更明显抑郁症状的抑郁症女性（汉密尔顿抑郁量表评分>8），其早期围绝经期过渡的风险是非抑郁症女性的两倍。在抑郁症状更严重的女性中（汉密尔顿评分>8），那些同时报告使用抗抑郁药的女性，其围绝经期过渡期提前的风险几乎是非抑郁女性的3倍（风险比，2.7; 95%置信区间，1.5-4.8）。有终生抑郁症史的女性在研究入组时和调整协变量后的随访期间也有较高的促卵泡激素和促黄体生成素水平，而较低的雌二醇水平。结论：终生抑郁症史可能与卵巢功能早期下降有关。
Background: Few studies have determined the impact of a lifetime history of major depression on an early transition to menopause.Methods: Reproductive and psychiatric interviews and early follicular-phase blood specimens were obtained at study enrollment and every 6 months during 36 months of follow-up from 332 women with and 644 women without a history of major depression, 36 to 45 years of age. We used menstrual cycle markers to determine inception of perimenopause, defined as time from study enrollment to a follow-up interview with: (1) 7-day or more change in menstrual cycle length; (2) a change in menstrual flow amount or duration; or (3) amenorrhea lasting at least 3 months.Results: Women with a history of depression had 1.2 times the rate of perimenopause of women with no such history (95% confidence interval, 0.9-1.6). Compared with nondepressed women, depressed women with more pronounced depressive symptoms at study enrollment (Hamilton Rating Scale for Depression scores >8) had twice the risk of an earlier perimenopausal transition. Among the women with greater depressive symptoms (Hamilton scores >8), those who also reported use of antidepressants had nearly 3 times the risk of an earlier perimenopausal transition (hazard ratio, 2.7; 95% confidence interval, 1.5-4.8) of nondepressed women. Women with a lifetime history of depression also had higher follicle-stimulating hormone and luteinizing hormone levels and lower estradiol levels at study enrollment and during the follow-up period after adjustment for covariates.Conclusion: A lifetime history of major depression may be associated with an early decline in ovarian function.