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Nomura K, Shimizu K, Taka F, Griffith-Quintyne M, Iida M. Scale development and validation of perimenopausal women disability index in the workplace. Environ Health Prev Med 2024; 29:4. [PMID: 38311393 PMCID: PMC10853391 DOI: 10.1265/ehpm.23-00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/30/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Menopausal disorders include obscure symptomatology that greatly reduce work productivity among female workers. Quantifying the impact of menopause-related symptoms on work productivity is very difficult because no such guidelines exist to date. We aimed to develop a scale of overall health status for working women in the perimenopausal period. METHODS In September, 2021, we conducted an Internet web survey which included 3,645 female workers aged 45-56 years in perimenopausal period. We asked the participants to answer 76 items relevant to menopausal symptomatology, that were created for this study and performed exploratory and confirmatory factor analyses for the scale development. Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis were used to verify the developed scale. RESULTS Approximately 85% participants did not have menstruation or disrupted cycles. Explanatory factor analysis using the maximum likelihood method and Promax rotation identified 21 items with a four-factor structure: psychological symptoms (8 items, α = 0.96); physiological symptoms (6 items, alpha = 0.87); sleep difficulty (4 items, alpha = 0.92); human relationship (3 items, alpha = 0.92). Confirmatory factor analyses found excellent model fit for the four-factor model (RMSR = 0.079; TLI = 0.929; CFI = 0.938). Criterion and concurrent validity were confirmed with high correlation coefficients between each of the four factors, previously validated menopausal symptom questionnaire, and Copenhagen Burnout Inventory scales, respectively (all ps < 0.0001). The developed scale was able to predict absenteeism with 78% sensitivity, 58% specificity, and an AUC of 0.727 (95%CI: 0.696-0.757). Higher scores of each factor as well as total score of the scale were more likely to be associated with work absence experience due to menopause-related symptoms even after adjusting for Copenhagen Burnout Inventory subscales (all ps < 0.0001). CONCLUSION We found that the developed scale has high validity and reliability and could be a significant indicator of absenteeism for working women in perimenopausal period.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Kisho Shimizu
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Fumiaki Taka
- Faculty of Sociology, Toyo University, Tokyo, Japan
| | - Melanie Griffith-Quintyne
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
| | - Miho Iida
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
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2
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Aragno E, Fagiolini A, Cuomo A, Paschetta E, Maina G, Rosso G. Impact of menstrual cycle events on bipolar disorder course: a narrative review of current evidence. Arch Womens Ment Health 2022; 25:257-266. [PMID: 35237876 DOI: 10.1007/s00737-022-01217-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/20/2022] [Indexed: 11/02/2022]
Abstract
Several lines of research suggest that reproductive-related hormonal events may affect the course of bipolar disorder in some women. However, data on associations between bipolar disorder and menarche, menstrual cycle, and menopause are mixed. This article reviews the literature on the potential effects of menarche, menstrual cycle, and menopause on bipolar disorder.A narrative review of published articles on bipolar disorder and menstrual cycle events was conducted. The primary outcome assessed was the impact of menarche, menstrual cycle and menopause on the course of bipolar illness. Databases searched were PubMed, Ovid, Scopus, PsycINFO, Medline, and Cochrane Libraries from inception to August 2021.Twenty-two studies were identified and included in the narrative synthesis. Research suggested that a subset of women with bipolar disorder are vulnerable to the impact of menstrual cycle events. Menarche seems to be associated with age at onset of bipolar illness especially in case of bipolar disorder type I and the specific age at menarche may predict some clinical features of the disorder. Menstrual cycle likely affects the course of bipolar disorder but the pattern of mood variability is not clear. Menopause appears to be not only a period of vulnerability to mood alteration, especially depressive episodes, and impairment of quality of life, but also a potential trigger of bipolar illness onset.The impact of menarche, menstrual cycle, and menopause on bipolar disorder is largely understudied. Preliminary evidence suggests that a subset of women with bipolar disorder may have their mood shifts affected by menstrual cycle events, with different patterns depending on the type of bipolar disorder also. Further researches are needed to deep the impact of menarche, menstrual cycle, and menopause on bipolar illness.
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Affiliation(s)
- Elena Aragno
- Department of Neurosciences "Rita Levi Montalcini", University of Torino, Turin, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | | | - Giuseppe Maina
- Department of Neurosciences "Rita Levi Montalcini", University of Torino, Turin, Italy.,Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy
| | - Gianluca Rosso
- Department of Neurosciences "Rita Levi Montalcini", University of Torino, Turin, Italy. .,Psychiatric Unit, San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy.
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3
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Li D, Xu W, Wu Q, Zheng H, Li Y. Ascorbic acid intake is inversely associated with prevalence of depressive symptoms in US midlife women: A cross-sectional study. J Affect Disord 2022; 299:498-503. [PMID: 34942225 DOI: 10.1016/j.jad.2021.12.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/30/2021] [Accepted: 12/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND With the endocrine changes in menopausal transition period, associations between dietary ascorbic acid intake and depressive symptoms may be different. This investigation examined cross-sectional relations between dietary ascorbic acid intake of women and prevalence of depressive symptoms. METHODS This is a secondary analysis performed on a subsample of the Study of Women's Health Across the Nation (SWAN). Women enrolled had measures of CES-D depression scores and ascorbic acid intake. Regression models were used to study cross-sectional associations between ascorbic acid intake and depressive symptoms. RESULTS A total of 3088 women aged 42-52 years at baseline were included in the present study. Dietary ascorbic acid intake was inversely associated with depressive symptoms. The adjusted OR and 95% CI of depressive symptoms was 0.699 (0.524 - 0.934) in quartile 4 (the highest) versus quartile 1 (the lowest) of the ascorbic acid intake. Restricted cubic spline analyze showed a suggestion of L-shaped associations between ascorbic acid intake and depressive symptoms. CONCLUSIONS Ascorbic acid intake is inversely associated with prevalence of depressive symptoms in midlife women. Future prospective cohort studies are needed to confirm these findings.
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Affiliation(s)
- Di Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Wanzhou Xu
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qing Wu
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hongyun Zheng
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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4
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Anderson MR, Wickramaratne P, Svob C, Miller L. Religiosity and Depression at Midlife: A Prospective Study. RELIGIONS 2021; 12. [PMID: 34900344 PMCID: PMC8664271 DOI: 10.3390/rel12010028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Previously, authors found high personal importance of religion/spirituality (R/S) in early adulthood to predict a 75% decreased risk of recurrence of major depression in middle adulthood. Here, the authors follow up the original study sample to examine the association between R/S and major depression from middle adulthood into midlife. Method: Participants were 79 of 114 original adult offspring of depressed and non-depressed parents. Using logistic regression analysis, three measures of R/S from middle adulthood (personal importance, frequency of religious service attendance, and denomination) were used to predict Major Depressive Disorder (MDD) in midlife. Results: High R/S importance in middle adulthood was prospectively associated with risk for an initial onset of depression during the period of midlife. Frequency of attendance in middle adulthood was associated with recurrence of depression at midlife in the high-risk group for depression, as compared to the low-risk group. Conclusion: Findings suggest that the relation between R/S and depression may vary across adult development, with risk for depression associated with R/S at midlife potentially revealing a developmental process.
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Affiliation(s)
- Micheline R. Anderson
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY 10027, USA
| | - Priya Wickramaratne
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032, USA
- Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Correspondence:
| | - Connie Svob
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Division of Epidemiology, New York State Psychiatric Institute, New York, NY 10032, USA
| | - Lisa Miller
- Spirituality Mind Body Institute, Teachers College, Columbia University, New York, NY 10027, USA
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5
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Martínez-Rodríguez A, Cuestas-Calero BJ, Martínez-Olcina M, Marcos-Pardo PJ. Benefits of Adding an Aquatic Resistance Interval Training to a Nutritional Education on Body Composition, Body Image Perception and Adherence to the Mediterranean Diet in Older Women. Nutrients 2021; 13:2712. [PMID: 34444872 PMCID: PMC8400619 DOI: 10.3390/nu13082712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 12/03/2022] Open
Abstract
The human population is increasing due to lengthening life expectancy, but the quality of life and health of people is moving in the opposite direction. The purpose of this study is to evaluate how aquatic resistance interval training can influence body composition, body image perception and adherence to the Mediterranean diet (MD) in older women participants in a nutrition education program and to study the relation between these variables. Thirty-four participants aged 69 ± 4 years were randomly assigned into two groups: experimental (aquatic resistance interval training plus nutritional intervention) and control (nutritional intervention). The intervention consisted of resistance training in an aquatic environment carried out for 14 weeks (three sessions per week; 60 min each). Body composition, body image perception and adherence to MD diet were evaluated at baseline and 14 weeks. No significant differences were found between groups regarding body image perception and adherence to the MD. There was a significant increase in muscle mass (kg) (p < 0.001) and a significant decrease in fat mass (kg) (p < 0.001) in the intervention group when compared to the control group. The addition of aquatic resistance interval training to a nutritional intervention was not sufficient to change body image perception and adherence to MD but produced improvement in body composition (through an increase in muscle mass and decrease on fat mass) in older women.
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Affiliation(s)
- Alejandro Martínez-Rodríguez
- Department of Analytical Chemistry, Nutrition and Food Science, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL Foundation), 03010 Alicante, Spain
| | | | - María Martínez-Olcina
- Department of Analytical Chemistry, Nutrition and Food Science, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain;
| | - Pablo Jorge Marcos-Pardo
- Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain;
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, 04120 Almería, Spain
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6
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Schach E, Kothari J, Perkiss E, Hutchinson-Colas J, Turock H, McGreevey J, Bachmann G. Symptomatic menopause: Additional challenges for incarcerated women. Maturitas 2021; 150:37-41. [PMID: 34274074 DOI: 10.1016/j.maturitas.2021.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 11/30/2022]
Abstract
Menopause is an age-associated physiological transition in women, usually occurring between the ages of 40 and 58 years, with an average of 51 years. As the age of women residing in the prison system is increasing globally, it becomes increasingly important for older female inmates to be assessed for menopausal symptoms and offered effective, personalized management. Middle-aged and older women, regardless of their living situation, are at increased risk of experiencing vasomotor symptoms and developing pelvic floor problems, bladder dysfunction and osteoporosis. However, all of these menopausal sequelae are typically exacerbated by prison conditions and by a lack of health support. Therefore, it is critical to implement prison programs and to create gender-specific training to aid in the health care needs of aging female inmates. Addressing this growing population of incarcerated women and attending to their menopausal needs require advocacy and active monitoring of prison-specific templates of care to ensure quality care. One such initiative legislated to address the health care needs of incarcerated women was commenced in New Jersey, USA. This entity, the NJ Commission on Women's Reentry, is addressing the unique health care needs of women, including menopausal ones, while incarcerated and then upon reentry into their community.
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7
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Payne JL, Umberson D, Kellogg E. Maternal Mental Health: Where Should Our Research and Policy Priorities Be? NAM Perspect 2020; 2020:202011g. [PMID: 35291738 DOI: 10.31478/202011g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | | | - Erin Kellogg
- National Academies of Sciences, Engineering, and Medicine
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8
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Gibbs Z, Lee S, Kulkarni J. The unique symptom profile of perimenopausal depression. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zoe Gibbs
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Melbourne, Victoria, Australia,
| | - Stuart Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Melbourne, Victoria, Australia,
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Melbourne, Victoria, Australia,
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9
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Raglan GB, Schulkin J, Micks E. Depression during perimenopause: the role of the obstetrician-gynecologist. Arch Womens Ment Health 2020; 23:1-10. [PMID: 30758732 DOI: 10.1007/s00737-019-0950-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/31/2019] [Indexed: 02/07/2023]
Abstract
Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.
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Affiliation(s)
- Greta B Raglan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA
| | - Elizabeth Micks
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195-6460, USA.
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10
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Figueira OA, Figueira HA, Figueira JA, Garcia AA, Figueira AA, Neto GM, Dantas EHM. Depression in Climacteric Women: Most Meaningful Symptoms. Health (London) 2019. [DOI: 10.4236/health.2019.114034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Bromberger JT, Epperson CN. Depression During and After the Perimenopause: Impact of Hormones, Genetics, and Environmental Determinants of Disease. Obstet Gynecol Clin North Am 2018; 45:663-678. [PMID: 30401549 PMCID: PMC6226029 DOI: 10.1016/j.ogc.2018.07.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vulnerability to depression is increased across the menopause transition and in the early years after the final menstrual period. Clinicians should systematically screen women in this age group; if depressive symptoms or disorder are present, treatment of depression should be initiated. Potential treatments include antidepressants for moderate to severe symptoms, psychotherapy to target psychological and interpersonal factors, and hormone therapy for women with first-onset major depressive disorder or elevated depressive symptoms and at low risk for adverse effects. Behavioral interventions can improve physical activity and sleep patterns.
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Affiliation(s)
- Joyce T Bromberger
- Department of Epidemiology, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Cynthia Neill Epperson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA; Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA; Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, 19104, USA
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12
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Kulkarni J, Gavrilidis E, Hudaib AR, Bleeker C, Worsley R, Gurvich C. Development and validation of a new rating scale for perimenopausal depression-the Meno-D. Transl Psychiatry 2018; 8:123. [PMID: 29955034 PMCID: PMC6023883 DOI: 10.1038/s41398-018-0172-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/04/2018] [Accepted: 04/22/2018] [Indexed: 12/28/2022] Open
Abstract
The menopause transition is a time when women experience an increased risk for new onset depression, as well as relapse of depression. While there are overlapping symptoms between major depression and depression during menopause, differences suggest 'perimenopausal depression' may be a unique subtype of depression associated with characteristic symptoms. There is currently no validated scale designed to measure perimenopausal depression. The aim of the current study was to develop and validate the 'Meno-D', a self-reporting or clinician rated questionnaire, designed to rate the severity of symptoms of perimenopausal depression. The development phase of the Meno-D involved literature review, clinical observation, and focus groups. A 12-item questionnaire was developed and clinically reviewed for face validity for content. The Meno-D was administered to women experiencing symptoms of perimenopausal depression as part of a larger baseline assessment battery. Validation involved confirmatory factor analysis (CFA). The development of the Meno-D resulted in 12 items. A total of 93 participants with perimenopausal depression were involved in the baseline assessments, 82 completed the Meno-D. Factor analysis identified five sub-scales of the Meno-D "somatic; cognitive; self; sleep; sexual" with high-internal consistency; discriminant validity and a good construct and convergent validity. The Meno-D provides a unique tool for clinicians and researchers to measure the presence of perimenopausal depression.
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Affiliation(s)
- Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia.
| | - Emorfia Gavrilidis
- Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Abdul-Rahman Hudaib
- Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Caitlin Bleeker
- Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Roisin Worsley
- Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia
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13
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Perich T, Ussher J, Meade T. Menopause and illness course in bipolar disorder: A systematic review. Bipolar Disord 2017; 19:434-443. [PMID: 28796389 DOI: 10.1111/bdi.12530] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 07/06/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Menopause may be a time of increased mood symptoms for some women. This systematic review aimed to examine the severity of symptoms and prevalence of mood changes in women with bipolar disorder during peri-menopause and post-menopause. METHODS A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The two primary outcomes assessed were relapse rates and symptom severity during menopause. Databases searched were MEDLINE, EMBASE, PsychInfo, CINAHL and SCOPUS from January 1980 until December 2016. RESULTS Nine studies, including a total of 273 participants diagnosed with bipolar disorder and who reported menopause, were included in the narrative synthesis. Menopause was reported to be associated with increased symptoms overall, and with depression in particular (range of 46%-91%). The collection of self-reported retrospective data was the most commonly used method to record menopause status. CONCLUSIONS The impact of menopause on illness course for women with bipolar disorder is largely under-explored. Preliminary evidence suggests that it may be associated with increased bipolar symptoms. Further work is needed to explore how menopause may interact with bipolar disorder over time and the nature of these symptom changes, and if and how menopause may differ from other reproductive stages.
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Affiliation(s)
- Tania Perich
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Jane Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Tanya Meade
- Clinical and Health Psychology Research Initiative (CaHPRI), School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,School of Medicine, University of Sydney, Sydney, NSW, Australia
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14
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Berent-Spillson A, Marsh C, Persad C, Randolph J, Zubieta JK, Smith Y. Metabolic and hormone influences on emotion processing during menopause. Psychoneuroendocrinology 2017; 76:218-225. [PMID: 27622993 PMCID: PMC5272799 DOI: 10.1016/j.psyneuen.2016.08.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 07/29/2016] [Accepted: 08/30/2016] [Indexed: 10/21/2022]
Abstract
Disturbances of emotion regulation and depressive symptoms are common during the menopause transition. Reproductive hormone levels are not directly correlated with depressive symptoms, and other factors may influence mood symptoms during menopause. In this study, we sought to determine the role of metabolic function in mood symptoms during menopause, hypothesizing an association with menopause status and long-term glucose load. We studied 54 women across three menopause transition stages (15 premenopause, 11 perimenopause, and 28 postmenopause), examining effects of age, hormones, and metabolism on mood and neural activation during emotional discrimination. We assessed participants using behavioral and functional MRI measures of negative emotion and emotion discrimination, and glycated hemoglobin A1c, to assess long-term glucose load. We found that emotionally unpleasant images activated emotion regulation (amygdala) and cognitive association brain regions (prefrontal cortex, posterior cingulate, temporal-parietal-occipital (TPO) junction, hippocampus). Cognitive association region activity increased with menopause stage. Perimenopausal women had left TPO junction activation, and postmenopausal women had prefrontal cortex, posterior cingulate, and TPO junction activation. Negative affect was associated with decreased amygdala activation, while depression symptoms and negative mood were associated with increased TPO junction activation. Hemoglobin A1c was associated with negative interpretation bias of neutral images and cognitive region recruitment during emotion discrimination. FSH levels, indicating menopause stage, were associated with negative mood. Age was not associated with any behavioral measures or activation patterns during the emotion task. Our results suggest that an interaction between metabolic and hormonal factors may influence emotion regulation, leading to increased risk for depression during menopause.
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Affiliation(s)
| | - Courtney Marsh
- Department of Obstetrics & Gynecology, University of Kansas, Kansas City, Kansas, USA, 66160
| | - Carol Persad
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA, 48109
| | - John Randolph
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, USA, 48109
| | - Jon-Kar Zubieta
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA, 84108
| | - Yolanda Smith
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, Michigan, USA, 48109
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15
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Qin DD, Rizak J, Feng XL, Yang SC, Lü LB, Pan L, Yin Y, Hu XT. Prolonged secretion of cortisol as a possible mechanism underlying stress and depressive behaviour. Sci Rep 2016; 6:30187. [PMID: 27443987 PMCID: PMC4957121 DOI: 10.1038/srep30187] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/30/2016] [Indexed: 02/05/2023] Open
Abstract
Stress is associated with the onset of depressive episodes, and cortisol hypersecretion is considered a biological risk factor of depression. However, the possible mechanisms underlying stress, cortisol and depressive behaviours are inconsistent in the literature. This study examined the interrelationships among stress, cortisol and observed depressive behaviours in female rhesus macaques for the first time and explored the possible mechanism underlying stress and depressive behaviour. Female monkeys were video-recorded, and the frequencies of life events and the duration of huddling were analysed to measure stress and depressive behaviour. Hair samples were used to measure chronic cortisol levels, and the interactions between stress and cortisol in the development of depressive behaviour were further evaluated. Significant correlations were found between stress and depressive behaviour measures and between cortisol levels and depressive behaviour. Stress was positively correlated with cortisol levels, and these two factors interacted with each other to predict the monkeys’ depressive behaviours. This finding extends the current understanding of stress/cortisol interactions in depression, especially pertaining to females.
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Affiliation(s)
- Dong-Dong Qin
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Joshua Rizak
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Xiao-Li Feng
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Shang-Chuan Yang
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Long-Bao Lü
- Kunming Primate Research Center, Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China
| | - Lei Pan
- Department of Rehabilitation Medicine, the Fourth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650021, China
| | - Yong Yin
- Department of Rehabilitation Medicine, the Fourth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650021, China
| | - Xin-Tian Hu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.,Kunming Primate Research Center, Chinese Academy of Sciences, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, 650223, China.,CAS Center for Excellence in Brain Science, Chinese Academy of Sciences, 320 Yue Yang Road, Shanghai, 200031, China
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16
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Bernard P, Ninot G, Bernard PL, Picot MC, Jaussent A, Tallon G, Blain H. Effects of a six-month walking intervention on depression in inactive post-menopausal women: a randomized controlled trial. Aging Ment Health 2015; 19:485-92. [PMID: 25133492 DOI: 10.1080/13607863.2014.948806] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Physical inactivity and advanced age are associated with risk of depressive disorders. Physical activity can reduce depressive symptoms in older subjects with depressive disorders. We investigated whether a walking intervention program may decrease the occurrence of depressive symptoms in inactive post-menopausal women without depression. METHOD A total of 121 participants aged 57-75 years were randomly assigned to a six-month moderate intensity walking intervention (three times a week, 40 minutes per session, supervised and home-based) or to a control group (waiting list). Inactivity was assessed using the Physical Activity Questionnaire for the Elderly. Depression levels were measured pre- and post-intervention with the Beck depression inventory (BDI). Several baseline measures were considered as possible predictors of post-intervention BDI score. RESULTS Participants in the walking intervention showed a significant decrease in depression as compared with controls. Baseline cognitive-BDI subscore, subjective health status, body mass index and adherence were post-intervention BDI score predictors. CONCLUSION A six-month, three-session per week, moderate intensity walking intervention with a minimal 50% adherence rate reduces depression in post-menopausal women at risk for depression due to physical inactivity. This type of walking intervention could be considered as a widely accessible prevention strategy to prevent depressive symptoms in post-menopausal women at risk of depression.
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Affiliation(s)
- P Bernard
- a Laboratory EA4556 Epsylon , Montpellier 1 University , Montpellier , France
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17
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Borkoles E, Reynolds N, Thompson DR, Ski CF, Stojanovska L, Polman RC. The role of depressive symptomatology in peri- and post-menopause. Maturitas 2015; 81:306-10. [DOI: 10.1016/j.maturitas.2015.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
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18
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Jung SJ, Shin A, Kang D. Hormone-related factors and post-menopausal onset depression: results from KNHANES (2010-2012). J Affect Disord 2015; 175:176-83. [PMID: 25622021 DOI: 10.1016/j.jad.2014.12.061] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 12/31/2014] [Accepted: 12/31/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although hypotheses have been proposed regarding the biological mechanisms of hormonal fluctuations in mood disorders, few epidemiological studies have addressed this issue. The aim of this study was to examine the association between hormone-related life events and postmenopausal depression. METHODS Of 13,918 women who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) V, a total of 4869 post-menopausal women who had completed information on depression onset age and additional reproductive factors were included in the analysis. A multivariate logistic regression was applied to calculate the odds ratios between reproductive factors and post-menopausal onset depression. RESULTS A total of 276 women (5.7%) were diagnosed with depression after menopause. Longer reproductive years were associated with a reduced risk of depression (for more than 35 reproductive years: OR=0.41, 95% CI: 0.27-0.62, P-trend<0.001). Similarly, a later age of menopause (52 years and older) corresponded to a decreased risk of depression (OR=0.35, 95% CI: 0.22-0.55) compared to the women with a menopausal age younger than 46 years. Greater numbers of pregnancies and exogenous hormone use were also associated with increased risk of depression. LIMITATIONS All data were collected from interviews using questionnaires. There may be some inaccuracies in recall of lifetime reproductive events, but women generally recalled their hormonal events correctly. CONCLUSION Early menopause and the use of exogenous hormones were associated with the risk of post-menopausal depression. Clinicians should closely monitor and consider further screening for depressed women who undergo early menopause or those with exogenous hormone use.
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Affiliation(s)
- Sun Jae Jung
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Daehee Kang
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
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19
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Richard A, Rohrmann S, Mohler-Kuo M, Rodgers S, Moffat R, Güth U, Eichholzer M. Urinary phytoestrogens and depression in perimenopausal US women: NHANES 2005-2008. J Affect Disord 2014; 156:200-5. [PMID: 24434020 DOI: 10.1016/j.jad.2013.12.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 12/20/2013] [Accepted: 12/20/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Fluctuating hormonal levels observed during the menopausal transition may increase vulnerability to depression in susceptible women. Thus, it is of interest to examine the effect of natural estrogens such as phytoestrogens on the risk of depression in perimenopausal women. METHODS Our analysis included 193 perimenopausal women of the National Health and Nutrition Survey (NHANES) 2005-2008 aged 45-55 years. Urinary concentrations of phytoestrogens (isoflavones and lignans) were measured by HPLC-APPI-MS/MS. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Logistic regression models examined the association of phytoestrogens concentrations (creatinine-standardized and log-transformed) with depression (yes/no). RESULTS Unadjusted odds ratios (OR) of the associations between urinary phytoestrogen concentrations and perimenopausal depression were below 1; however, only lignans were significantly inversely associated with depression. The latter findings were not attenuated in multivariate analysis including age, race, body mass index, poverty income ratio, smoking, alcohol consumption, cancer, diabetes, and cardiovascular disease (lignans: OR=0.66; 95% confidence intervals (CI) 0.50-0.87, enterodiol: OR=0.63; 95% CI 0.51-0.78, enterolactone: OR=0.75; 95% CI 0.60-0.93). LIMITATIONS Our cross-sectional study design does not allow for causal inferences. Because information to precisely assess perimenopausal symptoms was missing, we defined perimenopause based on women's age. CONCLUSIONS Lower lignans but not isoflavones concentrations were statistically significantly associated with an increased risk of depression in perimenopausal women. Because of medical risks associated with the use of hormone therapy, further investigation on the effect of lignans on the risk of depression in perimenopausal women is warranted.
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Affiliation(s)
- Aline Richard
- Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, CH-8001 Zürich, Switzerland.
| | - Sabine Rohrmann
- Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, CH-8001 Zürich, Switzerland
| | - Meichun Mohler-Kuo
- Mental Health and Social Epidemiology, Institute of Social and Preventive Medicine, University of Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland
| | - Rebecca Moffat
- University Hospital Basel, Women's Hospital, Switzerland
| | - Uwe Güth
- Cantonal Hospital Winterthur, Department of Gynecology and Obstetrics, Switzerland
| | - Monika Eichholzer
- Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, CH-8001 Zürich, Switzerland
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20
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Montesó-Curto P, Ferré-Grau C, Lleixà-Fortuño M, Albacar-Riobóo N, Lejeune M. Diagnosed, identified, current and complete depression among patients attending primary care in southern Catalonia: different aspects of the same concept. Arch Psychiatr Nurs 2014; 28:50-4. [PMID: 24506987 DOI: 10.1016/j.apnu.2013.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 09/14/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
Abstract
The aims of this study were to explore the prevalence and the conceptualizations of depression detected by the healthcare system, identified by the patient or classified/identified in the validated Goldberg's questionnaire in a community. We conducted a cross-sectional evaluation of 317 patients. The different types of depression diagnosed, identified, current or total were stratified by age and gender groups. The difference in the conceptualization of depression from the medical or ordinary people point of view indicate that depression care requires the understanding of the lifestyle, beliefs, attitudes, family and social networks of the people the physicians and nurses care for.
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Affiliation(s)
| | - Carme Ferré-Grau
- Department of Nursing. Rovira i Virgili University, Tarragona, Spain
| | | | | | - Marylene Lejeune
- Molecular Biology and Research Section, Hospital de Tortosa Verge de la Cinta, IISPV, URV, Tortosa, Spain
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21
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Mangweth-Matzek B, Hoek HW, Rupp CI, Kemmler G, Pope HG, Kinzl J. The menopausal transition--a possible window of vulnerability for eating pathology. Int J Eat Disord 2013; 46:609-16. [PMID: 23847142 DOI: 10.1002/eat.22157] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE No published studies, to our knowledge, have examined the association of menopausal status with eating disorders and body image in women. We assessed these associations in a large sample of middle-aged women. METHOD We administered an anonymous questionnaire to a randomly selected nonclinical sample of women aged 40-60 in Innsbruck, Austria. The questionnaire covered demographic items, menopausal status, weight history, measures of body image, and current eating disorders as diagnosed by DSM-IV criteria. Using modified WHO criteria, we classified the respondents' current stage of menopausal transition as premenopausal (N = 192), perimenopausal (N = 110), or naturally postmenopausal (N = 134). In a separate analysis, we also examined the small group of women with surgically induced menopause (N = 12). RESULTS The three groups were similar in all demographic features except age, and did not differ significantly on current body mass index (BMI), weight-control behaviors, or dieting history after age adjustment. However, perimenopausal women reported a significantly greater prevalence of eating disorders as compared to premenopausal women. Perimenopausal women also reported significantly higher self-ratings of "feeling fat" and higher Body Shape Questionnaire scores than premenopausal women. Women with surgically induced menopause also showed an elevated prevalence of eating and body image pathology. DISCUSSION Our data suggest that the menopausal transition is associated with an increased prevalence of eating disorders and negative body image. Menopause, like puberty, may perhaps represent a window of vulnerability to these conditions, likely because of changes in hormonal function, body composition, and conceptions of womanhood.
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Affiliation(s)
- Barbara Mangweth-Matzek
- Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria
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Greenspan H, Levitt WG, Berman J, Hussain A, Waseem S, Nandu B, Nehru V, Jaquish C. Worsening Depression in a Patient with a Granulosa Cell Tumor. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20130806-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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