Association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women.
Association between perimenopausal age and greater posttraumatic stress disorder and depression symptoms in trauma-exposed women.
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遭受创伤的女性围绝经期年龄与更大的创伤后应激障碍和抑郁症状之间的关联。
DOI：
10.1097/gme.0000000000002235
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Stevens,JenniferS
中科院分区：
文献类型：
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作者：
Michopoulos,Vasiliki;Huibregtse,MeganE;Chahine,EBritton;Smith,AliciaK;Fonkoue,IdaT;Maples-Keller,Jessica;Murphy,Amy;Taylor,Linzie;Powers,Abigail;Stevens,JenniferS
目的探讨绝经前、围绝经期和绝经后阶段与创伤后应激障碍（PTSD）和抑郁症状之间的关系。方法2005年至2017年进行的一项横断面研究从佐治亚州亚特兰大市格雷迪纪念医院（一家公共安全网医院）的非精神科门诊候诊室招募并纳入了城市社区样本（n= 6093）。参与者为女性，年龄在18至65岁之间，主要是黑人/非裔美国人。结果在6093名参与者中，93.8%为黑人/非裔美国人，2.5%为白人，3.8%为所有其他种族（西班牙裔/拉丁裔，亚洲人，多种族）。年龄小于40岁的参与者被归类为绝经前（n= 3166），年龄在40至55岁之间的参与者被归类为围绝经期（n= 2127），年龄大于55岁的参与者被归类为绝经后（n= 790）。绝经状态与总PTSD症状严重程度（f2, 5416= 9.61， P< 0.001）、所有三种PTSD症状群的症状严重程度（逃避/麻木症状：f2, 5416= 7.10， P< 0.001；侵入性症状：f2, 5416= 7.04， P< 0.001；高唤醒症状：f2, 5409= 8.31， P< 0.001）和抑郁症状严重程度（f2, 5148= 11.4， P< 0.001）相关。与绝经前和绝经后妇女相比，围绝经期妇女报告的总PTSD症状、高唤醒簇症状和抑郁症状明显加重。结论目前的横断面数据显示，女性PTSD和抑郁症的症状与生育年龄有关，围绝经期妇女的症状严重程度高于绝经前和绝经后妇女。未来的纵向研究可以揭示更年期过渡过程中激素的变化如何影响PTSD的症状、神经生物学和心理生理学。
ObjectiveThis study aimed to determine the relationship between stages of the menopause transition (premenopausal, perimenopausal, and postmenopausal) on symptoms of posttraumatic stress disorder (PTSD) and depression in trauma-exposed women.MethodsA cross-sectional study conducted between 2005 and 2017 recruited and enrolled an urban community sample (n= 6,093) from nonpsychiatric medical clinic waiting rooms of Grady Memorial Hospital, a public safety net hospital in Atlanta, Georgia. Participants were female, 18 to 65 years old, and predominantly Black/African American.ResultsOf the 6,093 participants, 93.8% were Black/African American, 2.5% were White, and 3.8% were of all other races (Hispanic/Latino, Asian, multiracial). Participants younger than 40 years were categorized as premenopausal (n= 3,166), between 40 and 55 years of age were categorized as perimenopausal (n= 2,127), and older than 55 years were categorized as postmenopausal (n= 790). Menopause status was associated with total PTSD symptom severity (F 2, 5416= 9.61, P< 0.001), symptom severity within all three PTSD symptom clusters (avoidance/numbing symptoms: F 2, 5416= 7.10, P< 0.001; intrusive symptoms: F 2, 5416= 7.04, P< 0.001; hyperarousal symptoms: F 2, 5409= 8.31, P< 0.001), and depression symptom severity (F 2, 5148= 11.4, P< 0.001). Compared with both premenopausal and postmenopausal women, perimenopausal women reported significantly worse total PTSD symptoms, symptoms in the hyperarousal cluster, and depressive symptoms.ConclusionsThe current cross-sectional data show that symptoms of PTSD and depression in women are associated with reproductive age, such that perimenopausal women show higher symptom severity than premenopausal and postmenopausal women. Future longitudinal studies can reveal how changes in hormones over the course of the menopause transition impact the symptoms, neurobiology, and psychophysiology of PTSD.