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NEW YORK (Reuters Health) Apr 04 – Women with no history of depression are at increased risk of developing depressive symptoms when they enter perimenopause, according to the results of two studies appearing in the Archives of General Psychiatry for April.
The transition to menopause is often considered a high-risk period for depressive symptoms, yet scientific evidence supporting this association is lacking, one of the research teams, led by Dr. Ellen W. Freeman from the University of Pennsylvania in Philadelphia, point out.
In an 8-year, longitudinal study, Dr. Freeman’s group looked at risk factors for depressed mood in 231 women who were about to enter menopause. All of the women had no history of depression at enrollment. The Center for Epidemiological Studies of Depression (CED-D) scale was used to assess depressive symptoms during follow-up.
The risk of a high CES-D score (at least 16) was 4.29-fold greater during the menopausal transition than during the premenopausal phase, the report indicates (p < 0.001). Similarly, the menopausal transition was tied to a 2.5-fold increased risk of being diagnosed with a depressive disorder (p = 0.01).
After adjusting for smoking, BMI, health status, and other factors, increased levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), as well as increased variability of estradiol were significantly associated with a high CES-D score.
“Further follow-up study is needed to determine the extent to which these reports of depressed mood are limited to the perimenopausal period and to determine whether the identified risk factors are associated with more persistent depression,” the authors state.
In a similar longitudinal study, Dr. Lee S. Cohen, from Massachusetts General Hospital in Boston, and colleagues looked at the impact of the menopausal transition on depressive symptoms in 460 women between 36 and 45 years old with no history of depression. During more than 3 years of follow-up, 134 women remained premenopausal and the remainder entered menopause.
The menopausal group was twice as likely to experience significant depressive symptoms than was the premenopausal group. A slightly higher risk was noted in menopausal women who reported vasomotor symptoms.
“Despite the fact that most women do not develop depression during the menopausal transition, the current study suggests that, relative to women who remain premenopausal, similarly aged women who begin the transition to menopause appear to be at an increased risk for first onset of depression ven in the absence of a history of depression,” the researchers conclude.
Arch Gen Psychiatry 2006;63:375-382,385-390.