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Kuck MJ, Hogervorst E. Stress, depression, and anxiety: psychological complaints across menopausal stages. Front Psychiatry 2024; 15:1323743. [PMID: 38455517 PMCID: PMC10917984 DOI: 10.3389/fpsyt.2024.1323743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction With the number of menopausal women projected estimated to reach 1.2 billion by 2030 worldwide, it is critically important to understand how menopause may affect women's emotional well-being and how many women are affected by this. This study aimed to explore (i) the relationship between psychological complaints (depression, anxiety, poor memory) across different menopausal stages and (ii) investigate the correlation between resilience, self-efficacy, and perceived stress levels, with psychological complaints and whether this was associated with menopausal stage and/or age. Methods 287 respondents completed the Menopausal Quality of Life (MenQoL), Perceived Stress Scale (PSS-10), Brief Resilience Scale (BRS), and General Self-efficacy (GSE) scales. Parametric and non-parametric analysis were used to analyse how bothered women were by self-reported poor memory and feelings of depression and anxiety, alongside perceived stress, resilience, and self-efficacy between women in different menopausal stages using STRAW criteria. The association between protective factors (self-efficacy and resilience) and psychological complaints was analysed with partial correlation analysis controlling for menopausal stages and/or age. Results A significant difference was found between the levels of perceived stress, and how bothered women were by feelings of depression and anxiety between early-perimenopausal and post-menopausal women. However, with the inclusion of age as a covariate, menopausal stage no longer predicted the level of self-reported stress and anxiety in menopausal women. There was also no difference between poor self-reported memory, or of self-efficacy or resilience between women in different menopausal stages. However, self-efficacy and resilience were associated with how bothered women were by feelings of depression and anxiety, and the experience of stress. Stress was the only variable to be associated with poor self-reported memory independent of age and/or menopausal status. Discussion Early perimenopausal women experienced the highest level of stress and were more severely bothered by feelings of depression and anxiety, with the poorest overall self-reported psychosocial quality of life. Post-menopausal women, however, reported to have similar experiences as premenopausal women. Age explained the associations between menopausal stage, stress and anxiety, but not between depression and different menopausal stages. Resilience and self-efficacy were associated with psychological complaints independent of menopausal stage and age, suggesting that therapies focusing on increasing resilience and self-efficacy may be beneficial to help target these psychological complaints at any time.
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Affiliation(s)
- Ming Jun Kuck
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
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Brimienė I, Šiaudinytė M, Burokas A, Grikšienė R. Exploration of the association between menopausal symptoms, gastrointestinal symptoms, and perceived stress: survey-based analysis. Menopause 2023; 30:1124-1131. [PMID: 37788428 DOI: 10.1097/gme.0000000000002259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVE The study aimed to evaluate the relationship between menopausal symptoms, gastrointestinal symptoms, and experienced stress in women from premenopause to postmenopause. METHODS We conducted a cross-sectional study using an anonymous survey that included questions on demographics, health (gynecological, gastrointestinal), and lifestyle (physical activity, sleep, etc) factors, the Perceived Stress Scale (PSS), and the Menopause-Specific Quality of Life Questionnaire (MENQOL). RESULTS Data of 693 participants aged 50.1 ± 3.2 years were analyzed. We found that the MENQOL total score increased depending on the stages of reproductive aging ( P < 0.001) and positively correlated with PSS scores ( r = 0.47, P < 0.001). Age, reproductive stage, body mass index (BMI), PSS score, diagnosis of depression or anxiety disorder, physical activity, and frequency of defecation appeared to have significant association with the total MENQOL score ( P < 0.05). The analysis within separate MENQOL domains revealed that PSS score and diagnosis of depression or anxiety disorder were associated with higher scores in all MENQOL domains ( P < 0.05) except sexual. Physical activity and the values of the Bristol stool form scale were related to the vasomotor items ( P < 0.05). The frequency of defecation was an independent contributor to the psychosocial and sexual domains ( P < 0.05). BMI, physical activity, and frequency of defecation were associated with physical symptoms ( P < 0.05). CONCLUSIONS Perceived stress and some gastrointestinal symptoms in women were associated with menopausal symptoms. Reproductive stages, physical activity, BMI, and previously diagnosed depression or anxiety disorder were related to the intensity of menopausal symptoms. However, further research is needed to confirm the relationship between stress, gastrointestinal, and menopausal symptoms.
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Affiliation(s)
| | | | - Aurelijus Burokas
- Department of Biological Models, Institute of Biochemistry, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Ramunė Grikšienė
- From the Department of Neurobiology and Biophysics, Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
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Li R, Liu S, Huang C, Darabi D, Zhao M, Heinzel S. The influence of perceived stress and income on mental health in China and Germany. Heliyon 2023; 9:e17344. [PMID: 37408921 PMCID: PMC10318459 DOI: 10.1016/j.heliyon.2023.e17344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023] Open
Abstract
Background Mental health issues affect rich and poor, young and old, and are widespread in Asia as well as in Europe. However, few studies have investigated the influence of perceived stress and income on mental health among general population in China and in Germany. Methods We conducted an online survey from December 2021 to February 2022 to investigate how perceived stress and income affect mental health among the general population in China (N = 1123) and in Germany (N = 1018). Accordingly, we used the 10-item Perceived Stress Scale (PSS-10) and the 12-item General Health Questionnaire (GHQ-12). We ran a multiple linear regression model to investigate the relationship between perceived stress, income, and mental health. Results Overall, we found that 53.4% participants reported mental health issues (GHQ-12 score ≥12). The proportion of our sample who reported mental health issues was higher in Germany (60.3%) than in China (44.8%). The regression model revealed that a higher perceived stress score was associated with more mental health issues in both countries (b = 0.60, p < 0.01). Individuals with a low income reported poorer mental health in Germany than those in China. Interestingly, the situation was reversed when incomes were high: individuals with a high income reported worse mental health in China than in Germany (b = -0.40, p < 0.01). Conclusion Perceived stress has a negative impact on mental health, while income has differential effects. Mental health promotion programmes may involve teaching stress management, while considering differences in mental health outcomes in developed and developing countries.
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Affiliation(s)
- Ruihua Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Shuyan Liu
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Chuanning Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Debora Darabi
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin (Campus Charité Mitte), Berlin, Germany
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
| | - Stephan Heinzel
- Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Garcia de leon R, Baaske A, Albert AY, Booth A, Racey CS, Gordon S, Smith LW, Gottschlich A, Sadarangani M, Kaida A, Ogilvie GS, Brotto LA, Galea LA. Higher perceived stress during the COVID-19 pandemic increased menstrual dysregulation and menopause symptoms. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231199051. [PMID: 37732492 PMCID: PMC10515540 DOI: 10.1177/17455057231199051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The increased stress the world experienced with the coronavirus disease (COVID-19) pandemic affected mental health, disproportionately affecting females. However, how perceived stress in the first year affected menstrual and menopausal symptoms has not yet been investigated. OBJECTIVES This study evaluates the effect that the first year of the COVID-19 pandemic had on female reproductive and mental health. METHODS Residents in British Columbia, Canada, were surveyed online as part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex. A subgroup of participants (n = 4171), who were assigned female sex at birth (age 25-69 years) and were surveyed within the first 6-12 months of the pandemic (August 2020-February 2021), prior to the widespread rollout of vaccines, was retrospectively asked if they noticed changes in their menstrual or menopausal symptoms, and completing validated measures of stress, depression and anxiety. DESIGN This is a population-based online retrospective survey. RESULTS We found that 27.8% reported menstrual cycle disturbances and 6.7% reported increased menopause symptoms. Those who scored higher on perceived stress, depression and anxiety scales were more likely to report reproductive cycle disturbances. Free-text responses revealed that reasons for disturbances were perceived to be related to the pandemic. CONCLUSION The COVID-19 pandemic has highlighted the need to research female-specific health issues, such as menstruation. Our data indicate that in the first year of the pandemic, almost one-third of the menstruating population reported disturbances in their cycle, which was related to percieved stress, depression and anxiety scores.
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Affiliation(s)
| | | | | | - Amy Booth
- Women’s Health Research Institute, Vancouver, BC, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - C. Sarai Racey
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Shanlea Gordon
- Women’s Health Research Institute, Vancouver, BC, Canada
| | | | - Anna Gottschlich
- Women’s Health Research Institute, Vancouver, BC, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Manish Sadarangani
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | - Angela Kaida
- Women’s Health Research Institute, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Gina S. Ogilvie
- Women’s Health Research Institute, Vancouver, BC, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Lori A. Brotto
- Women’s Health Research Institute, Vancouver, BC, Canada
- Department of Obstetrics and Gynaecology, The University of British Columbia, Vancouver, BC, Canada
| | - Liisa A.M. Galea
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Lee J, Lee JE. Psychological well-being of midlife women: a structural equation modeling approach. Menopause 2022; 29:440-449. [PMID: 35231003 DOI: 10.1097/gme.0000000000001933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Women experience menopause at approximately 50 to 52 years of age, when reproductive aging causes various somatic, psychological, and urogenital symptoms. Women's changing lifestyles and increasing lifespan make it difficult to pinpoint the factors affecting their well-being during menopause, warranting continuous research in this field. Therefore, this study developed a structural equation model, based on the transactional model of stress and coping, to test the significance of positive and negative factors associated with psychological health during menopause. METHODS This study validated a structural equation model based on the empirical data collected using a crosssectional study. We analyzed 300 questionnaire responses completed between May 15 and July 10, 2020, by South Korean middle-aged women (aged 45-60 y) who agreed to participate. The study's structural equation model used self-efficacy as an exogenous variable and perceived stress, menopausal management, self-compassion, menopausal symptoms, and psychological well-being as endogenous variables. Educational and economic levels were set as control variables. RESULTS We observed statistical support for 9 out of 10 hypotheses; the predictor variables had an explanatory power of 79.5% for psychological well-being. Self-efficacy was positively associated with the psychological wellbeing of middle-aged menopausal women and appeared to be mediated by perceived stress, menopausal management, menopausal symptoms, and self-compassion. CONCLUSIONS To improve the psychological well-being of middle-aged women, it is important to increase their self-efficacy and minimize stress. Moreover, managing menopausal symptoms and increasing self-compassion through effective coping may maximize psychological well-being. VIDEO SUMMARY http://links.lww.com/MENO/A933.
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Affiliation(s)
- Jiwon Lee
- Department of Nursing, Dongnam Health University, Suwon, Gyeonggi-do, Republic of Korea; and
| | - Jong-Eun Lee
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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Symvoulakis EK, Volkos P, Markaki A, Linardakis M. Emotional Discomfort Scale: Instrument Development and Association With General Self-Efficacy and Data From an Urban Primary Care Setting. Cureus 2022; 14:e21495. [PMID: 35223272 PMCID: PMC8860711 DOI: 10.7759/cureus.21495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction: Sense of discomfort, which is experienced in daily encounters, can develop into stress, coexist with stress, or interplay with self-efficacy. This study presents two objectives, namely, to develop and test a new instrument called the Emotional Discomfort (EmoD) Scale and to compare the EmoD with the General Self-Efficacy (GSE) Scale. Methods: The study was conducted in an urban primary healthcare center in Greece over a three-week period in 2020. Out of 314 individuals invited to participate, 263 accepted and completed the questionnaire. The EmoD is a five-point Likert-type eight-item scale for assessing individual reaction and sense of discomfort in daily life situations. Results: Cronbach’s α for the new scale reached 0.730 (acceptable reliability). Participants who used psychotropic drugs scored higher in the EmoD scale compared with nonusers. GSE scores showed reverse associations with EmoD scores. Multiple linear regression analysis indicated that an increase in self-efficacy, as measured using the GSE scale, was associated with a reduction in sense of discomfort, as measured by the EmoD scale. Conclusions: The use of the EmoD scale can aid health or social care providers in detecting levels of emotional discomfort, a finding that is demonstrated to interplay with self-efficacy. Future studies employing the use of this new instrument could examine emotional discomfort in relation to stress coping and social isolation.
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Ak Sözer G, Güdül Öz H, Yangın H. Relationship between menopausal symptoms and perceived stress during the COVID-19 pandemic. J Women Aging 2021; 34:675-686. [PMID: 34661513 DOI: 10.1080/08952841.2021.1985374] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This study aimed to examine the relationship between menopausal symptoms and perceived stress in middle-aged women during the COVID-19 pandemic. In this cross-sectional study, data were collected online from 239 middle-aged women using the Personal Information Form, Menopause Rating Scale (MRS) and Perceived Stress Scale-14 (PSS-14). A positive correlation was found between the total MRS score and the total PSS-14 score. The COVID-19 pandemic usually restrict access to healthcare visit. The COVID-19 pandemic has created an urgent need to implement specific menopausal programs to promote the psychological health of middle-aged women and reduce stress during this or similar crises.
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Affiliation(s)
- Gülşen Ak Sözer
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
| | - Hatice Güdül Öz
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
| | - Hatice Yangın
- Department of Maternity and Gynecological Nursing, Akdeniz University Nursing Faculty, Antalya, Turkey
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