Does risk for anxiety increase during the menopausal transition? Study of women's health across the nation.
Does risk for anxiety increase during the menopausal transition? Study of women's health across the nation.
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DOI：
10.1097/gme.0b013e3182730599
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发表时间：
2013-05
期刊：
影响因子：
--
通讯作者：
Matthews KA
中科院分区：
文献类型：
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作者：
Bromberger JT;Kravitz HM;Chang Y;Randolph JF Jr;Avis NE;Gold EB;Matthews KA
人们对女性在中年和更年期过渡期间出现焦虑的风险知之甚少。在对2956名不同种族/民族的女性进行了10年的跟踪调查后，我们检查了焦虑的4种症状，并确定了绝经阶段与高度焦虑之间的关联。这项研究是对全国妇女健康多点研究(SWAN)数据的纵向分析，这是一项关于更年期和老龄化的研究。在研究开始时，女性比例为42比52。结果是高度焦虑，根据前两周的频率从0(无)到4(每天)(20%以上)，四种焦虑症状的总和为4或更高。协变量包括社会人口学、健康因素、应激源和血管运动症状(VMS)。与绝经前相比，基线焦虑程度低的女性在绝经早期或晚期或绝经后更有可能报告高焦虑症状(优势比从1.56到1.61)，独立于多种风险因素，包括令人不安的生活事件、经济压力、一般/较差的健康状况和VMS。在整个随访过程中，处于基线高度焦虑的女性仍有较高的焦虑率，但优势比并不因绝经阶段而异。绝经前高度焦虑的女性可能是慢性焦虑，在绝经过渡的特定阶段不会增加高度焦虑的风险。相比之下，绝经前低焦虑的女性在绝经过渡期间和之后可能比绝经前更容易受到高焦虑的影响。
Little is known about the risk of anxiety in women during midlife and the menopausal transition. We examined anxiety as a cluster of 4 symptoms and determined the association between menopausal stage and high anxiety during ten years of follow-up of 2,956 women of multiple race/ethnicities. This study was a longitudinal analysis of data from the multi-site Study of Women's Health Across the Nation (SWAN), a study of menopause and aging. Women were 42-52 at study entry. The outcome was high anxiety, a score of 4 or greater on the sum of four anxiety symptoms rated according to frequency in the previous 2 weeks from 0 (none) to 4 (daily) (upper 20%). Covariates included sociodemographics, health factors, stressors, and vasomotor symptoms (VMS). Women with low anxiety at baseline were more likely to report high anxiety symptoms when early or late perimenopausal or postmenopausal compared to when they were premenopausal (odds ratios ranged from 1.56 to 1.61), independent of multiple risk factors, including upsetting life events, financial strain, fair/poor perceived health, and VMS. Women with high anxiety at baseline continued to have high rates of high anxiety throughout the follow-up but odds ratios did not differ by menopausal stage. Women with high anxiety premenopausally may be chronically anxious and not at increased risk of high anxiety at specific stages of the menopausal transition. In contrast, women with low anxiety premenopausally may be more susceptible to high anxiety during and after the menopausal transition than before.