Depressive symptoms and menopausal burden in the midlife.
Depressive symptoms and menopausal burden in the midlife.
复制标题
中年的抑郁症状和更年期负担。
DOI：
10.1016/j.maturitas.2009.01.002
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发表时间：
2009
期刊：
影响因子：
4.9
通讯作者：
Bush,Terry
中科院分区：
文献类型：
--
作者：
Reed,SusanD;Ludman,EvetteJ;Newton,KatherineM;Grothaus,LouisC;LaCroix,AndreaZ;Nekhlyudov,Larissa;Spangler,Leslie;Jordan,Luesa;Ehrlich,Kelly;Bush,Terry
目的本研究的目的是评估绝经期症状是否在有抑郁症状的女性中更常见和/或更严重。方法对两家大型综合健康计划（西雅图和波士顿）的1358名45-70岁妇女进行横断面调查。收集了人口统计学、医疗和生殖史、药物使用、更年期经历和抑郁症状（PHQ-8）的信息。接受HT治疗的女性被排除在外。调整了年龄和体重指数的Logistic回归模型检验了更年期症状（潮热、盗汗、阴道干燥和性交困难）与存在中度/重度抑郁症状之间的关联。结果共纳入770名女性；98例（12.7%）有中度/重度抑郁症状，672例（87.3%）无/轻度抑郁症状。有中度/重度抑郁症状的女性报告近期血管舒缩症状（潮热和/或盗汗）的可能性几乎是没有/轻度抑郁症状的女性的两倍（调整优势比（aOR） 1.67, 95%CI 1.94 - 2.68），并报告其为重度（aOR 1.63, 95%CI 0.95-2.83）。尽管20%有中度/重度抑郁症状的女性（4.6%无/轻度抑郁症状）正在使用SSRI或SNRI类药物（已知可改善血管舒缩症状的药物），但仍观察到更高的症状负担。有更年期症状的妇女百分比和有严重血管舒缩症状的妇女百分比与抑郁症状得分呈线性相关。结论抑郁症状“放大”了绝经期体验，或者严重的血管舒缩症状加重了抑郁症状。
OBJECTIVEThe goal of this study was to assess whether menopausal symptoms were more common and/or more severe among women with depressive symptoms.METHODSA cross-sectional survey of 1358 women, ages 45–70, at two large integrated health plans (Seattle; Boston) was performed. Information on demographics, medical and reproductive history, medication use, menopausal experience and depressive symptoms (PHQ-8) were collected. Women taking HT were excluded. Logistic regression models adjusted for age and body mass index tested the associations between menopausal symptoms (hot flushes, night sweats, vaginal dryness and dyspareunia) and presence of moderate/severe depressive symptoms.RESULTS770 women were included; 98 (12.7%) had moderate/severe depressive symptoms and 672 (87.3%) had no/mild depressive symptoms. Women with moderate/severe depressive symptoms were almost twice as likely to report recent vasomotor symptoms (hot flashes and or night sweats) vs. women with no/mild depressive symptoms (adjusted odds ratio (aOR) 1.67, 95%CI 1.04–2.68), and to report them as severe (aOR 1.63, 95%CI 0.95–2.83). A higher symptom burden was observed despite the fact that 20% of women with moderate/severe depressive symptoms (vs. 4.6% no/mild depressive symptoms) were using an SSRI or SNRI, medications known to improve vasomotor symptoms. The percentage of women with menopausal symptoms, and the percentage with severe vasomotor symptoms were linearly associated with the depressive symptom score.CONCLUSIONSDepressive symptoms “amplified” the menopausal experience, or alternatively, severe vasomotor symptoms worsened depressive symptoms.