Depression in Female Adolescents with Heavy Menstrual Bleeding.
Depression in Female Adolescents with Heavy Menstrual Bleeding.
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DOI：
10.1016/j.jpeds.2021.09.007
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发表时间：
2022-01
影响因子：
5.1
通讯作者：
Choi, Sung W.
中科院分区：
文献类型：
--
作者：
Weyand, Angela C.;Fitzgerald, Kate D.;McGrath, Mary;Gupta, Vibhuti;Braun, Thomas M.;Quint, Elisabeth H.;Choi, Sung W.
为了评估月经过多出血的程度（与抑郁症相关，与激素避孕无关）。我们对 1168 名 9-18 岁的女性进行了一项回顾性队列研究，这些女性向普通儿科医生就诊 HMB 或健康检查。抑郁症是主要结果，并被定义为健康记录中的诊断。单变量和多变量回归模型与数据拟合，以确定与抑郁症诊断相关的因素。581 名患有 HMB 的青少年和 587 名没有 HMB 的青少年进行了回顾性队列研究。与没有 HMB 的青少年相比，患有 HMB 的青少年抑郁症诊断的频率更高（50.9% vs 24.2% p<0.001；风险比为 1.67，95% CI：1.39–2.01），但服用与未服用激素避孕的青少年之间没有显着差异（RR 0.99（95% CI 0.84–1.17）。大多数抑郁症患者。 HMB 在 HMB 后或同时发生抑郁症（261/296，88%），其中 199/261（76%）接受激素避孕，但大多数（168/199（84%））在开始治疗前被诊断为抑郁症，在多变量分析、协变 HMB、年龄、 BMI、焦虑、性活动和药物使用通常用于治疗 HMB，因此 HMB 可能在一定程度上导致了先前关于服用激素避孕药的患者抑郁风险增加的报道。
To assess the degree to which heavy menstrual bleeding (is associated with depression, independent of hormonal contraception. We performed a retrospective cohort study of 1168 females 9–18 years old presenting to general pediatricians for HMB or well visits. Depression was the primary outcome and defined as a diagnosis in the health record. Univariable and multivariable regression models were fit to the data to identify factors associated with depression diagnosis. 581 adolescents with HMB and 587 without HMB were included. Depression diagnoses occurred with greater frequency in youth with HMB compared to those without HMB (50.9% vs 24.2% p<0.001; risk ratio of 1.67, 95% CI: 1.39–2.01), but did not significantly differ between those taking versus not taking hormonal contraception (RR 0.99 (95%CI 0.84–1.17). Most patients with depression and HMB developed depression following or concurrent with HMB (261/296, 88%). Of these, 199/261 (76%) were treated with hormonal contraception but the majority (168/199 (84%)) were diagnosed with depression prior to initiation. HMB is associated with depression diagnosis in adolescent females. Use of hormonal contraception was not associated with depression diagnosis in multivariable analysis, covarying HMB, age, BMI, anxiety, sexual activity, and substance use. As hormonal contraception is often used to treat HMB, HMB may be partially driving previous reports of increased depression risk in those taking hormonal contraception.
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