Depressive symptoms during the menopausal transition: The study of women's health across the nation (SWAN)
Depressive symptoms during the menopausal transition: The study of women's health across the nation (SWAN)
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DOI：
10.1016/j.jad.2007.01.034
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发表时间：
2007-11-01
影响因子：
6.6
通讯作者：
Randolph, John F., Jr.
中科院分区：
文献类型：
--
作者：
Bromberger, Joyce T.;Matthews, Karen A.;Randolph, John F., Jr.
背景：在不同民族中，绝经状态对抑郁症状的影响尚不清楚。这项研究考察了更年期状态的变化与临床相关抑郁症状风险之间的纵向关系，以及这种关系是否根据最初的抑郁症状水平的不同而不同。方法：从1995年到2002年，3302名年龄在42-52岁的非裔美国人、中国人、西班牙裔、日本人和白人妇女参加了全国妇女健康研究(SWAN)，这是一项基于社区的多点纵向观察研究。采用随机效应多因素Logistic回归分析来确定绝经状态与5年来抑郁症状评分高低的关系。结果：基线时，23%的样本中有23%的人CES-D评分升高。与绝经前相比，围绝经期早期、围绝经期晚期、绝经后或目前/以前使用激素治疗(HT)的女性更有可能报告CES-D>；=16(OR范围为1.30至1.71)。在基线水平上，CES-D得分较低的女性的效果更强。健康和心理社会因素增加了高CES-D的几率，在某些情况下，比绝经状态更重要。限制：我们使用了对当前抑郁症状的衡量，而不是对临床抑郁症的诊断。因此，我们只能对年度评估中当前的症状做出结论。结论：大多数中年女性没有经历高度抑郁症状。这些人在围绝经期或绝经后比绝经前更有可能经历高度抑郁症状，而不受支付基本生活费用的困难、消极态度、感觉健康状况差和压力事件等因素的影响。(C)2007 Elsevier B.V.保留所有权利。
Background: The influence of menopausal status on depressive symptoms is unclear in diverse ethnic groups. This study examined the longitudinal relationship between changes in menopausal status and the risk of clinically relevant depressive symptoms and whether the relationship differed according to initial depressive symptom level.Methods: 3302 African American, Chinese, Hispanic, Japanese, and White women, aged 42-52 years at entry into the Study of Women's Health Across the Nation (SWAN), a community-based, multisite longitudinal observational study, were evaluated annually from 1995 through 2002. Random effects multiple logistic regression analyses were used to determine the relationship between menopausal status and prevalence of low and high depressive symptom scores (CES-D < 16 or >= 16) over 5 years.Results: At baseline, 23% of the sample had elevated CES-D, scores. A woman was more likely to report CES-D >= 16 when she was early peri-, late peri-, postmenopausal or currently/formerly using hormone therapy (HT), relative to when she was premenopausal (OR range 1.30 to 1.71). Effects were somewhat stronger for women with low CES-D scores at baseline. Health and psychosocial factors increased the odds of having a high CES-D and in some cases, were more important than menopausal status.Limitations: We used a measure of current depressive symptoms rather than a diagnosis of clinical depression. Thus, we can only make conclusions about symptoms current at annual assessments.Conclusion: Most midlife women do not experience high depressive symptoms. Those that do are more likely to experience high depressive symptom levels when perimenopausal or postmenopausal than when premenopausal, independent of factors such as difficulty paying for basics, negative attitudes, poor perceived health, and stressful events. (C) 2007 Elsevier B.V. All rights reserved.