Investigation of Social and Circadian Rhythm Dysregulation in the Development of Depression Symptoms During the Menopause Transition

项目摘要 绝经过渡期是发展为临床显著抑郁症的高危时期。 女性的症状。在过渡到更年期(即围绝经期)期间患抑郁症的可能性为 大约是绝经期前的3倍。迫切需要了解 这些抑郁症发病率上升的机制为预防和风险管理提供了最佳信息 战略。更年期的昼夜节律会改变，并且与抑郁症有广泛的联系 尤其是更年期女性。最近的研究还表明，对雌激素波动的敏感性 可能与生殖过渡期间的抑郁症状有关。还没有彻底解决的问题 阐明的是1)昼夜节律改变与抑郁症的发展有关的程度 围绝经期的症状和2)昼夜节律的改变是否纯粹受 荷尔蒙的变化或环境对社会节律的失调。这份R21提案的目标是 同时探讨荷尔蒙和社会节律对昼夜节律的影响 在进入更年期的妇女中，有(n=20)和没有(n=20)有明显临床症状的 抑郁症(MDD)。基线评估将包括临床访谈和自我报告 抑郁症的测量，对当前压力源及其对日常生活的影响的详细访谈，以及 关于睡眠、时型和社会节奏规律性的问卷调查。参与者还将完成一次抽血 抽出生殖荷尔蒙雌激素和卵泡刺激素。在4周的时间里， 参与者将每4天提供一次早晨唾液中的雌二醇和黄体酮样本，总共7次 样本。参与者还将在研究期间佩戴手腕活动记录仪，以检查休息/活动节奏 并参与每日一次的情绪、压力和例行公事的生态瞬间评估，以便 更深入地分析可能影响昼夜节律和情绪的背景因素。在第4周结束时， 参与者将接受重复抽血，并完成对压力和情绪的后续评估。这些 这些方法将为研究昼夜节律和社会节律的中介作用的R01奠定基础 围绝经期大样本和多样化样本中抑郁症状发展的干扰 女人。

Project Summary The menopausal transition is a high-risk period for the development of clinically significant depression symptoms in women. The likelihood of depression during the transition to menopause (i.e., perimenopause) is approximately 3 times greater relative to the pre-menopause period. There is a critical need to understand the mechanisms of these increased depression rates to optimally inform prevention and risk-management strategies. Circadian rhythms are altered in menopause and have been linked to depression broadly and in menopausal women specifically. Recent research has also shown that sensitivity to fluctuations in estrogen may be linked to depression symptoms during this reproductive transition. What has yet to be thoroughly elucidated is 1) the degree to which altered circadian rhythms are linked to the development of depression symptoms during the perimenopausal period and 2) whether circadian alterations are influenced purely by hormonal changes or also by environmental dysregulation of social rhythms. The goal of this R21 proposal is to explore simultaneously the relationship of both hormonal and social rhythm influences on circadian rhythms in women transitioning into menopause both with (n=20) and without (n=20) clinically significant symptoms of major depressive disorder (MDD). Baseline assessments will include clinical interview and self-report measures of depression, a detailed interview of current stressors and their impact on daily routines, and questionnaires about sleep, chronotype, and social rhythm regularity. Participants will also complete a blood draw for reproductive hormones estradiol and follicle stimulating hormone. Over the course of 4 weeks, participants will provide morning salivary samples of estradiol and progesterone every 4 days for a total of 7 samples. Participants will also wear a wrist actigraph during the study period to examine rest/activity rhythms and participate in once daily ecological momentary assessments of mood, stress, and routines allowing for deeper analysis of contextual factors that may affect circadian rhythms and mood. At the end of week 4, participants will undergo a repeat blood draw and complete follow-up assessments of stress and mood. These methods will set the stage for an R01 that will investigate the mediational role of circadian and social rhythm disruption in the development of depression symptoms in a large and diverse sample of perimenopausal women.