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Jia Y, Zhou Z, Xiang F, Hu W, Cao X. Global prevalence of depression in menopausal women: A systematic review and meta-analysis. J Affect Disord 2024; 358:474-482. [PMID: 38735578 DOI: 10.1016/j.jad.2024.05.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this includes women in perimenopause and postmenopause). METHODS PubMed, Web of Science, Embase, and PsycINFO databases were systematically searched from database inception until March 1, 2024. Studies with validated methods for assessing the prevalence of depression in perimenopausal and postmenopausal women were included. Two authors independently extracted relevant data. Random effects meta-analysis and Meta-regression analysis were performed using Stata software. RESULTS Total of 55 studies (76,817 participants) were included in the review. A random effects model was used to calculate pooled prevalence. The pooled depression prevalence in menopausal women was 35.6 % (95 % CI: 32.0-39.2 %), with 33.9 % (95 % CI: 27.8-40.0 %) in perimenopausal women, and 34.9 % (95 % CI: 30.7-39.1 %) in postmenopausal women. Subgroup analyses indicated that region, screening tool, study design, and setting moderated the prevalence of depression. Meta-regression indicated that smaller sample sizes and poorer study quality were significantly associated with a higher prevalence. LIMITATIONS There was a high degree of heterogeneity across the included studies. Only articles published in English were included. There was significant publication bias in this meta-analysis. There is insufficient information about many risk factors of menopausal depression in current meta-analysis. CONCLUSIONS Depression is common among menopausal women worldwide. To reduce the negative impact of depression on health outcomes in menopausal women, regular screening and the availability of effective prevention and treatment measures should be made available for this population.
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Affiliation(s)
- Yu Jia
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Zitong Zhou
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Feng Xiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Wanqin Hu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Sichuan, China
| | - Xuehua Cao
- Department of Gynecology Nursing, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan, China.
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Li J, Liu F, Liu Z, Li M, Wang Y, Shang Y, Li Y. Prevalence and associated factors of depression in postmenopausal women: a systematic review and meta-analysis. BMC Psychiatry 2024; 24:431. [PMID: 38858633 PMCID: PMC11165857 DOI: 10.1186/s12888-024-05875-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Depression is a prevalent mental health problem in postmenopausal women. Given its significant impact on the quality of life and overall well-being of postmenopausal women, there is need for a comprehensive review and meta-analysis of the existing research globally. This systematic review and meta-analysis evaluated the global prevalence of depression and potential associated factors in postmenopausal women. METHODS The Cochrane Library, PubMed, EMBASE, Web of Science, MEDLINE, and PsycINFO databases were systematically searched from inception to March 22, 2023. The meta-analysis used the random-effects model to calculate the prevalence of depression rates and associated factors. In addition, subgroup analysis and sensitivity analysis were performed. Publication bias was assessed using funnel plots, Egger's test, and nonparametric trim-and-fill tests. RESULTS The meta-analysis included 50 studies that involved 385,092 postmenopausal women. The prevalence of depression in postmenopausal women was 28.00% (95% CI, 25.80-30.10). Among the factors relevant to depression among postmenopausal women, marital status (OR: 2.03, 95%CI: 1.33-3.11), history of mental illness (OR: 2.31, 95%CI: 1.50-3.57), chronic disease (OR: 3.13, 95%CI: 2.20-4.44), menstrual cycle (OR: 1.42, 95%CI: 1.17-1.72), abortion numbers (OR: 1.59, 95%CI: 1.40-1.80), menopausal symptoms (OR: 2.10, 95%CI: 1.52-2.90), and hormone replacement therapy (OR: 1.76, 95%CI: 1.31-2.35) were risk factors, while physical activity (OR: 0.56, 95%CI: 0.53-0.59), number of breastfed infants (OR: 0.43, 95%CI: 0.19-0.97), menopause age (OR: 0.44, 95%CI: 0.37-0.51) were preventive factors. CONCLUSIONS This study demonstrated that the prevalence of postmenopausal depression is high, and some risk factors and protective factors associated with it have been identified. It is necessary to improve screening and management and optimize prevention and intervention strategies to reduce the harmful effects of postmenopausal depression.
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Affiliation(s)
- Jiaxin Li
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Fangli Liu
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China.
- Institution of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China.
- Xinyang Vocational and Technical College, Xinyang, Henan, P. R. China.
| | - Ziwei Liu
- The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, P. R. China
| | - Mengjie Li
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Yingying Wang
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Yameng Shang
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
| | - Yuege Li
- School of Nursing and Health, Henan University, Kaifeng, Henan, P. R. China
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Li H, Sheng LT, Tai BC, Pan A, Koh WP. Association between Dietary Antioxidant Capacity in Midlife and Depressive Symptoms in Late Life: The Singapore Chinese Health Study. Antioxidants (Basel) 2024; 13:576. [PMID: 38790681 PMCID: PMC11118857 DOI: 10.3390/antiox13050576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/04/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
Preclinical and limited epidemiological studies suggest that oxidative stress may be implicated in geriatric depression. Our study investigated the association between midlife dietary total antioxidant capacity (TAC) and depressive symptoms in late life among 13,712 participants in a population-based cohort of Chinese in Singapore. At baseline (1993-1998), intake of antioxidants from diet and supplements at a mean age of 52.4 years was estimated using a validated food frequency questionnaire to derive two dietary TAC indices from vitamins C and E, carotenoids and flavonoids: the Comprehensive Dietary Antioxidant Index (CDAI) and Vitamin C Equivalent Antioxidant Capacity (VCEAC). At follow-up 3 (2014-2016), when participants were at a mean age of 72.5 years, depressive symptoms were assessed using the Geriatric Depression Scale, and depression, defined as having ≥5 symptoms, was presented in 3173 (23.1%) participants. Both CDAI and VCEAC indices were inversely associated with odds of depressive symptoms in a stepwise manner: the OR (95% CI) comparing the extreme quartiles was 0.73 (0.64-0.83; Ptrend < 0.01) for the CDAI and 0.77 (0.68-0.87; Ptrend < 0.01) for the VCEAC. Specifically, higher intakes of vitamin C, carotenoids, and flavonoids were associated with a lower likelihood of depressive symptoms. Our findings support the recommendation of an antioxidant-rich diet for the prevention of depression.
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Affiliation(s)
- Huiqi Li
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore;
| | - Li-Ting Sheng
- Phase I Clinical Trial Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215000, China
- Drug Clinical Trial Center, Peking University Third Hospital, Beijing 100191, China
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore;
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore 138632, Singapore
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Prevalence and risk factors for depressive and anxiety symptoms in middle-aged Chinese women: a community-based cross-sectional study. BMC Womens Health 2022; 22:319. [PMID: 35906641 PMCID: PMC9338469 DOI: 10.1186/s12905-022-01908-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background Depression and anxiety have become main public health concerns globally. However, risk factors for depression and anxiety remain unclear. This study was to examine the prevalence and risk factors of depressive and anxiety symptoms in middle-aged Chinese women. Methods This cross-sectional study, conducted in 2018, included 7,727 women aged 40–60 years from the eastern, central and western regions of China. Depressive and anxiety symptoms were determined by the Patient Health Questionnaire-9 and the Generalized Anxiety Disorders-7, respectively. Logistic regression models were used to estimate odds ratios (ORs) for depressive and anxiety symptoms in relation to sociodemographic, lifestyle and menopausal factors. Results Among all participants, 19.5% (1 422/7 275) and 14.2% (1 035/7 275) of participants experienced depressive and anxiety symptoms, respectively. The multivariable logistic regression models showed that age, household income, regular physical activity, chronic diseases, menopausal status, vasomotor symptoms, somatic symptoms and urogenital symptoms were associated with depressive symptoms, while place of residence, regular physical activity, chronic diseases, vasomotor, somatic and urogenital symptoms were associated with anxiety symptoms. Conclusion Depressive and anxiety symptoms were common among middle-aged Chinese women, and certain sociodemographic, lifestyle and menopausal symptoms have an important impact on the risk of depressive and anxiety symptoms.
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Biopsychosocial risk factors of depression during menopause transition in southeast China. BMC Womens Health 2022; 22:273. [PMID: 35790958 PMCID: PMC9258098 DOI: 10.1186/s12905-022-01710-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/11/2022] [Indexed: 12/05/2022] Open
Abstract
Objective More than 2 billion women are experiencing menopause transition in China and some of them suffered from depression; while the risk factors of depression during menopause transition were still unclearin China. We aimed to investigate the risk factors in mid-life women in Southeast China.
Method This study included 1748 Chinese women aged 40–65 years-old who visited gynecology outpatient department of Women’s hospital School of Medicine, Zhejiang University during 2010–2018. Demographic information was collected, and the modified Kupperman Menopausal Index (mKMI) and Hamilton Rating Scale for Depression were assessed. Circulating levels of sex hormones were tested. Ordinal logistic regression analysis was performed to identify risk factors for depression. Results The prevalence of depression symptoms was 47.43%. The majority of women had mild (38.56%) or moderate depressive symptoms (8.00%); only 0.86% had severe depressive symptoms. Compared with perimenopausal women, postmenopausal women had increased risks of more severe depression. The associations between menopausal syndromes and the intensity of depression were strongly positive (OR 6.69, 95% CI 5.39–8.29). Elder age, higher follicle stimulating hormone levels, lower estradiol levels, and fewer parity were positively related with the intensity of depression. Among postmenopausal women, underweight, mKMI > 14, earlier age at menopause, shorter reproductive period, and longer duration after menopause were risk factors for incresed intensity of depression. Conclusions The results demonstrated a high proportion of depression in women complaining of menopause. Menopausal symptoms were strongly related to the intensity of depression. In postmenopausal women, estrogen related events are associated with the intensity of depression. Gynecological endocrinologists in China should consider screening for depression in high-risk women. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01710-4.
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Bittoni C, Kiesner J. Sexual Desire in Women: Paradoxical and Nonlinear Associations with Anxiety and Depressed Mood. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3807-3822. [PMID: 36123564 PMCID: PMC9663363 DOI: 10.1007/s10508-022-02400-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 06/01/2023]
Abstract
The aim of the present study was to expand previous findings regarding paradoxical effects of negative mood on sexual desire. This was done by considering the full range of depressed mood and anxiety symptoms and using methods that are unaffected by recall bias and that don't require participants to infer causal associations between their mood and sexual desire. A convenience sample of 213 university students completed daily questionnaires for approximately two months. Multilevel random-effects models were used to estimate average effects for the entire sample and to test for variability across participants in the associations between negative mood and sexual desire, controlling also for potential influences of the menstrual cycle. Previous findings showing that some women report decreased sexual desire and others increased sexual desire when depressed or anxious were confirmed. More importantly, for both depressed mood and anxiety, results demonstrated the presence of within-person paradoxical associations, whereby there were some women for whom both low and high levels of negative mood were associated with the same change (an increase or a decrease) in sexual desire. Related to these diverse response patterns, paradoxical associations between negative mood and sexual desire were also present at low levels of negative mood. The discussion underlines the importance of considering individual variability and multifactorial nonlinear models when studying sexual desire.
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Affiliation(s)
- Celeste Bittoni
- Department of Development and Social Psychology, University of Padova, via Venezia 8, 35131, Padua, Italy
| | - Jeff Kiesner
- Department of Development and Social Psychology, University of Padova, via Venezia 8, 35131, Padua, Italy.
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Çalişkan Pala S, Ünsal A, Arslantaş D, Öcal EE, Dağtekin G. Evaluation of depression, social support and quality of life in perimenopausal and postmenopausal women in semi-rural Turkey. Psychogeriatrics 2022; 22:679-687. [PMID: 35778987 DOI: 10.1111/psyg.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/22/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study aimed to determine the prevalence of depression in perimenopausal and postmenopausal women in a semi-rural area in a city in Turkey and to evaluate perceived social support and quality of life by examining some of the variables thought to be related. METHODS The study was conducted on 827 perimenopausal and postmenopausal women aged 40-60 years. The questionnaire included sociodemographic characteristics, some variables associated with depression, questions from the Beck Depression Inventory, Multidimensional Scale of Perceived Social Support, and European Health Impact Scale - Quality of Life-8 (EUROHIS-QOL-8) scale. RESULTS The prevalence of depression was 23.1% (n = 191) in the study. The prevalence of depression was found to be higher in single/widowed/separated individuals (odds ratio (OR): 2.539; 95% CI: 1.593-4.047) and at poor income levels (1.980; 1.000-3.021). The frequency of depression was found to be lower in those who gave birth once or twice (0.470; 0.294-0.752), those with a high level of social support (0.959; 0.948-0.971), and those with a high level of QOL (0.836; 0.794-0.879). There was a moderate negative correlation between the depression scale and QOL scale scores (r = -0.405, P = 0.001). A weak negative correlation was found between depression and social support scores (r = -0.383, P = 0.001). CONCLUSION Women are more vulnerable to depression in premenopausal and postmenopausal periods. Being single/widowed, having a poor income level, having low social support, and low QOL are important risk factors which increase the frequency of depression.
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Affiliation(s)
| | - Alaettin Ünsal
- Eskisehir Osmangazi University, Department of Public Health, Eskişehir, Turkey
| | - Didem Arslantaş
- Eskisehir Osmangazi University, Department of Public Health, Eskişehir, Turkey
| | - Ece Elif Öcal
- Ardahan Provincial Health Directorate, Ardahan, Turkey
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Trends and Geographic Variabilities in Benzodiazepines Prescription in Primary Care to Older Adults: A 3-Year Population-Based Ecological Study in Portugal. Healthcare (Basel) 2022; 10:healthcare10071342. [PMID: 35885868 PMCID: PMC9324858 DOI: 10.3390/healthcare10071342] [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] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/24/2022] Open
Abstract
(1) Background: According to the World Health Organization (WHO), benzodiazepines (BZD) are considered essential medicines for the treatment of several mental disorders in older adults over 65 years old. However, the long-term use of BZD could present a harmful impact on this population, leading to cognitive deficits, drug dependence, falls, and fractures. This study aims to analyze trends of BZD prescription to Portuguese older adults in the primary care setting, and to analyze the change in the prescription rate of BZD over time, assessing the geographical variability in mainland Portugal. (2) Methods: A nationwide, retrospective ecological study was performed between January 2019 and December 2021 for BZD prescribing data reported in a national public database for all persons aged 65 and older in mainland Portugal (about 2.4 million). Trends of BZD by defined daily doses (DDD) and per 1000 older adults’ inhabitants per day (DID) were analyzed. (3) Results: A total of 19 BZD were included in this study and more than 1 million BZD prescriptions were recorded in each year of this study period. BZD prescriptions were three times higher in females than in males. Alprazolam, lorazepam, diazepam, ethyl loflazepate, and bromazepam were the most prescribed BZD over the years, presenting the higher DDD and DID values. (4) Conclusions: Despite the DID value growth of several BZD, Portugal is now showing stable BZD prescriptions in older adults, between the years 2019 to 2021. More studies are needed to access if these results are a consequence of successful health programs or just a consequence of the pandemic context that we are facing, which limited older adults’ clinical appointments.
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Schöler D, Kostev K, Demir M, Luedde M, Konrad M, Luedde T, Roderburg C, Loosen SH. An Elevated FIB-4 Score Is Associated with an Increased Incidence of Depression among Outpatients in Germany. J Clin Med 2022; 11:jcm11082214. [PMID: 35456304 PMCID: PMC9032098 DOI: 10.3390/jcm11082214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Liver disease and depression are known to be closely associated. Non-invasive tests (NIT), such as the FIB-4 score, have been recommended by different guidelines to rule out advanced fibrosis and to stratify the risk of liver-related outcomes in patients with chronic liver diseases. However, the predictive value of an elevated FIB-4 score regarding the development of depression and/or anxiety disorders among the general population is unknown. Methods: By using the Disease Analyzer database (IQVIA), which compiles diagnoses and laboratory values as well as basic medical and demographic data of patients followed in general practices in Germany, we identified 370,756 patients with available lab values for FIB-4 score calculation between 2005 and 2019. Patients with an FIB-4 score < 2 were matched 1:1 to patients with an FIB-4 index ≥ 2 by age, sex and yearly consultation frequency. Results: In regression analysis, the incidence rate ratio (IRR) of depression was significantly higher among patients with an FIB-4 score ≥ 2.0 compared to patients with a lower FIB-4 score <2.0 (IRR: 1.12, p < 0.001). This association was significant for both female (IRR: 1.10, p = 0.004) and male (IRR: 1.15, p < 0.001) patients and strongest in the age groups ≤50 years (IRR: 1.42, p < 0.001) and 51-60 years (IRR: 1.34, p < 0.001). There was no significant association between an elevated FIB-4 score ≥ 2.0 and the incidence of depression among patients aged 60 years and older. There was no significant increase in the IRR of anxiety disorders for patients with high or low FIB-4 scores. Conclusion: Our study suggests a previously unknown association between an elevated FIB-4 score and an increased incidence of depression. This finding suggests that the FIB-4 score is not only a valuable tool for the prediction of liver-specific endpoints but also may be of relevance for the prediction of extrahepatic comorbidities, which in turn may argue for clinical screening programs in patients with an elevated FIB-4.
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Affiliation(s)
- David Schöler
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
| | | | - Münevver Demir
- Clinic for Hepatology and Gastroenterology, Charité University Medical Center, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Mark Luedde
- KGP Bremerhaven, 27574 Bremerhaven, Germany;
| | - Marcel Konrad
- FOM University of Applied Sciences for Economics and Management, 60549 Frankfurt am Main, Germany;
| | - Tom Luedde
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
| | - Christoph Roderburg
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
- Correspondence: (C.R.); (S.H.L.); Tel.: +49-211-81-16330 (C.R. & S.H.L.)
| | - Sven H. Loosen
- Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.S.); (T.L.)
- Correspondence: (C.R.); (S.H.L.); Tel.: +49-211-81-16330 (C.R. & S.H.L.)
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Prevalence of post-menopausal depression and associated factors: A web-based cross-sectional study in Greece. Maturitas 2022; 156:12-17. [PMID: 35033228 DOI: 10.1016/j.maturitas.2021.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 07/29/2021] [Accepted: 10/24/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The impact of depression on post-menopausal women is an important public health issue but remains largely unknown. The purpose of this study was to identify the prevalence of post-menopausal depression in Greece and outline the profile of the women it affects. STUDY DESIGN A sample of post-menopausal women completed an anonymous, self-administered, web-based survey which included the Beck Depression Inventory-ΙΙ (BDI-II) and questions regarding socio-demographic data. MAIN OUTCOME MEASURES The dependent variable of interest was a BDI-II score ≥ 20 (the cut-off for moderate depression according to the BDI). RESULTS Overall, 502 post-menopausal women participated in the study. The median BDI-II score was 13 (range 0-50); 136 (27.1%) of the women scored ≥ 20 and were considered screen-positive for depression. According to the multivariate logistic regression model, age< 55 years (OR: 1.621; 95% CI: 1.036-2.535), not working (OR: 1.580; 95% CI: 1.013-2.465), smoking (OR: 1.656; 95% CI: 1.081-2.536) and history of depression (OR: 1.650; 95% CI: 1.045-2.604) were independently associated with post-menopausal depression. Subgroup analyses revealed that current smokers (OR: 2.514; 95% CI: 1.485-4.256) had higher odds of moderate depression, while obesity (OR: 2.455; 95% CI: 1.206-4.996), absence of healthcare insurance (OR: 4.413; 95% CI: 1.970-9.887) and a history of depression (OR: 2.253; 95% CI: 1.212-4.190) were identified as independent risk factors for severe post-menopausal depression. CONCLUSIONS More than one out of four post-menopausal women were screen-positive for symptoms indicative of depression, while a personal history of depression, age < 55 years, smoking and current working status were independent predictors of its emergence.
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Rodrigues DA, Plácido AI, Tavares AB, Azevedo D, Mateos-Campos R, Figueiras A, Herdeiro MT, Roque F. Potentially Inappropriate Medication Prescribing in Older Adults According to EU(7)-Potentially Inappropriate Medication List: A Nationwide Study in Portugal. Curr Ther Res Clin Exp 2022; 97:100681. [PMID: 35937773 PMCID: PMC9350873 DOI: 10.1016/j.curtheres.2022.100681] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/04/2022] [Indexed: 10/25/2022] Open
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Papazisis G, Tsakiridis I, Apostolopoulou A, Papaefstathiou E, Bellali T, Liozidou A, Pappa A, Ainatzoglou A, Tzitiridou M, Billis A, Dagklis T. The Greek translation and validation of the electronic version of the Meno-D rating scale for post-menopausal depression. Health Informatics J 2022; 28:14604582221080100. [PMID: 35435749 DOI: 10.1177/14604582221080100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Menopausal transition and post-menopause constitute windows of increased vulnerability to depression. Recently, the Meno-D was introduced, a novel 12-item, with five distinct subscales. The aim of our study was to translate and validate the electronic version of the Meno-D among Greek post-menopausal women. Translation and back-translation were performed by an expert group, while face validity was assessed by five experts. Along with the Beck Depression Inventory-II, the Meno-D scale was distributed online to 502 post-menopausal women. A confirmatory factor analysis was performed to investigate construct validity and both convergent and discriminant validity were evaluated. The data analysis was performed using Statistical Package for Social Sciences and AMOS. The 5-factor model of Meno-D achieved adequate levels of goodness-of-fit indices, scoring lower values in discriminant validity examined with heterotrait-monotrait ratio and composite reliability. The significant correlation with the Beck Depression Inventory-ΙΙ revealed for all subscales was indicative of good convergent validity. An exploratory factor analysis was additionally performed, suggesting a 12-item tool comprising two subscales: (i) psychological and (ii) biological and achieving good levels of fit. Our data confirmed that the electronic version of Meno-D is a valid tool that can be used for screening and evaluation of depression in Greek post-menopausal women.
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Affiliation(s)
| | - Ioannis Tsakiridis
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Aikaterini Apostolopoulou
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Efstathios Papaefstathiou
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Thalia Bellali
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Athanasia Liozidou
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Athanasia Pappa
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Alexandra Ainatzoglou
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Maria Tzitiridou
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Antonis Billis
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
| | - Themistoklis Dagklis
- Clinical Trials Unit, Special Unit for Biomedical Research and Education, School of Medicine, 30133Aristotle University of Thessaloniki, Greece
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Yılmaz S, Arslan I, Yengil Taci D. The effect of physical activity and depressive mood on menopausal symptoms in postmenopausal women. Int J Clin Pract 2021; 75:e14247. [PMID: 33887084 DOI: 10.1111/ijcp.14247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/01/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022] Open
Abstract
AIMS The symptoms of menopause in postmenopausal women adversely affect the quality of life. Menopausal symptoms are more severe with comorbid disorders such as depression; it may be lighter in physically active people. The present study aimed to evaluate the relationship between menopausal symptoms and physical activity and depressive mood. MATERIAL AND METHOD One hundred and ninety women under 65 years of age who were at least 1 year passed since their last menstrual period participated in the study. Sociodemographic data form, Menopause Symptom Rating Scale, International Physical Activity Questionnaire-Short Form and Beck's Depression Inventory were applied to the participants. RESULTS It was seen that 51.6% (98 subjects) of the women who participated in the study had severe menopausal symptoms. 52.6% (100 subjects) of the participants were physically inactive, and their menopausal symptoms increased as the physical activity scale score decreased (P = .001). Menopausal symptoms increased as the Beck's Depression Inventory score increased (P < .001). It was observed that depression inventory scores decreased as the level of physical activity increased (P < .001). CONCLUSION Adoption of regular physical activity habits by postmenopausal women and providing treatment to those with depression will contribute to alleviating the severity of menopausal symptoms.
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Affiliation(s)
- Selin Yılmaz
- Department of Family Medicine, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ismail Arslan
- Department of Family Medicine, Ankara Training and Research Hospital, Ankara, Turkey
| | - Duygu Yengil Taci
- Department of Family Medicine, Ankara Training and Research Hospital, Ankara, Turkey
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Zhou J, Wang X, Feng L, Xiao L, Yang R, Zhu X, Shi H, Hu Y, Chen R, Boyce P, Wang G. Venlafaxine vs. fluoxetine in postmenopausal women with major depressive disorder: an 8-week, randomized, single-blind, active-controlled study. BMC Psychiatry 2021; 21:260. [PMID: 34011310 PMCID: PMC8135153 DOI: 10.1186/s12888-021-03253-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the population of postmenopausal patients with major depressive disorder (MDD), the superiority of serotonin-norepinephrine reuptake inhibitors (SNRIs) over selective serotonin reuptake inhibitors (SSRIs) has not yet been definitively proven. Consequently, a direct comparison of the efficacy of SSRIs and SNRIs in the treatment of postmenopausal depression could provide relevant data. The aim of this study was to compare the efficacy and safety of venlafaxine vs. fluoxetine in the treatment of postmenopausal MDD. METHODS This was an 8-week, multicenter, randomized, single-blind, active-controlled trial conducted at a psychiatric hospital (Beijing Anding Hospital) and a general hospital (Beijing Chaoyang Hospital) between April 2013 and September 2017. The primary outcome measure was improving depressive symptoms (Hamilton Depression Rating Scale (HAMD-24) score). The secondary outcomes included the change of HAMD-24 anxiety/somatization factor score and Clinical Global Impressions-Improvement (CGI-I) response rate. Safety was assessed by treatment-emergent adverse events (TEAEs) and laboratory tests. Efficacy was analyzed by using the full analysis set (FAS) following the modified intention-to-treat (mITT) principle. The primary endpoint measurements were analyzed using a mixed-effect model for repeated measures (MMRM) model with patients as a random-effect factor, treatment group as the independent variable, time as a repeated measure, and baseline covariates, using a first-order ante dependence covariance matrix. RESULTS A total of 184 women were randomized. The full analysis set (FAS) included 172 patients (venlafaxine, n = 82; fluoxetine, n = 90). Over the 8-week study period, the reduction in HAMD-24 scores was significant (P < 0.001) in both groups, while a significantly greater decline from baseline was observed in the venlafaxine group compared with the fluoxetine group (least-squares mean difference [95% CI]: - 2.22 [- 7.08, - 0.41]), P = 0.001). The baseline-to-week-8 least-squares mean change of the anxiety/somatization factor scores, CGI-I response rate were greater in the venlafaxine group than in the fluoxetine group (all P < 0.05). The most frequent TEAEs (≥5%) in both groups were nausea, somnolence, dizziness, headache, and dry mouth. There was no significant difference in the incidence of adverse events between the two groups. CONCLUSION Venlafaxine was well tolerated and compared to fluoxetine, it led to a greater improvement in the treatment of postmenopausal MDD. TRIAL REGISTRATION Clinical Trials. gov #NCT01824433 . The trial was registered on April 4, 2013.
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Affiliation(s)
- Jingjing Zhou
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiao Wang
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China
| | - Lei Feng
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Le Xiao
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Rui Yang
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xuequan Zhu
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China
| | - Hui Shi
- grid.411607.5Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yongdong Hu
- grid.411607.5Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Runsen Chen
- grid.24696.3f0000 0004 0369 153XThe National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088 China ,grid.24696.3f0000 0004 0369 153XAdvanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China ,grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Philip Boyce
- grid.1013.30000 0004 1936 834XDiscipline of Psychiatry, Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW Australia ,grid.413252.30000 0001 0180 6477Department of Psychiatry, Westmead Hospital, Sydney, Australia
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, No 5. Ankang Lane, Deshengmen Wai, Xicheng District, Beijing, 100088, China. .,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Abstract
OBJECTIVE This study aimed to determine the frequency of depression in postmenopausal women, examine some variables that are thought to be related, and evaluate the relationships between postmenopausal depression, anxiety, and fear of death. METHODS The study is a cross-sectional study conducted among postmenopausal women who applied to an Obstetrics and Gynecology Polyclinic in Sakarya, Turkey, between March and September 2018. The study group consisted of 485 postmenopausal women. For statistical analysis, the chi-square test, logistic regression analysis, Mann-Whitney U test, and Spearman correlation analysis were used. Values of P ≤ 0.05 were accepted as statistically significant. RESULTS The ages of the participants ranged between 35 and 78 years, and the average was 56.33 ± 7.34 years. Being a widow or separated from one's partner (odds ratio [OR]: 3.478), alcohol consumption (OR: 11.772), any history of illness that required continuous medication (OR: 3.579), presence of any physical disability (OR: 2.242), history of any mental disorder with a physician's diagnosis (OR: 4.213), and number of living children 4 or more (OR: 4.174) were found to be important risk factors for postmenopausal depression. A moderate positive correlation was found between the depression scale and the scores obtained from the anxiety scale (r = 0.467; P = 0.001). No difference was found between participants with and without depression in terms of fear of death. CONCLUSION Depression among postmenopausal women is an important health problem that needs to be studied further. No relation was found between depression and fear of death. These results will be beneficial for raising awareness about depression among postmenopausal women and conducting screening for early diagnosis.
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Depressive Symptoms and Healthy Behavior Frequency in Polish Postmenopausal Women from Urban and Rural Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062967. [PMID: 33799359 PMCID: PMC8001997 DOI: 10.3390/ijerph18062967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/06/2021] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
The objective of this study was to determine whether the severity of depressive symptoms was linked to healthy behaviors in Polish postmenopausal women and whether the strength of the link differed between women living in urban versus rural settings. The study was conducted in 2018 in the Lublin region of Poland and included 396 postmenopausal women (239 living in rural areas and 157 in urban areas). The severity of depressive symptoms was evaluated by the Beck Depression Inventory (BDI) and the frequency of healthy behaviors was assessed using the Inventory of Healthy Behaviors. Postmenopausal women living in rural areas underwent menopause significantly earlier, were more often widowed, more often obese, more often less educated, and less likely to have never married when compared to those living in urban areas. Importantly, rural postmenopausal women endorsed more depressive symptoms (p = 0.049). There was a negative correlation between the severity of depressive symptoms and age in urban postmenopausal women (r = −0.174, p = 0.029), but this was not evident in rural women (r = −0.034, p = 0.600). The frequency of healthy behaviors was significantly lower in rural postmenopausal women, especially with respect to nutritional habits. A positive correlation was found between the frequency of healthy behaviors and the level of education in both sets of women (p = 0.034 and p = 0.045, respectively). To summarize, we found a significant link between healthy behaviors and depressive symptoms in postmenopausal women. We also found that this link was more evident in rural than in urban women.
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Wu YT, Huang WY, Kor CT, Liu KH, Chen TY, Lin PT, Wu HM. Relationships between depression and anxiety symptoms and adipocyte-derived proteins in postmenopausal women. PLoS One 2021; 16:e0248314. [PMID: 33667284 PMCID: PMC7935290 DOI: 10.1371/journal.pone.0248314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/23/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Studies on the association between adiponectin and leptin and anxiety and depression among postmenopausal women are limited. Therefore, the present study specifically evaluates the mutual relationships between adiponectin and leptin and anxiety and depression in postmenopausal women. PARTICIPANTS AND DESIGN In this cross-sectional study, a total of 190 women aged 40-65 years were enrolled. Depression symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and anxiety symptoms were evaluated using the Hamilton Anxiety Rating Scale (HAM-A). Fasting specimens were collected to measure sex hormone, glucose, insulin, and adipokine levels. Multiple linear regression analysis was performed to evaluate the associations between depression and anxiety and adipocyte-derived hormones. SETTINGS The study was performed in a hospital medical center. RESULTS Among 190 enrolled postmenopausal women, Spearman's rank correlation analysis revealed significant correlations between CES-D and HAM-A (r = 0.715, P < 0.0001), between CES-D and adiponectin (p = 0.009) and leptin (p = 0.015), and between HAM-A and adiponectin (p = 0.01) and leptin (p = 0.001). The subjects with CES-D ≥ 16 and with HAM-A ≥ 18 had higher adiponectin levels than those with CES-D < 16 and HAM-A < 18, respectively. After adjusting for age, body mass index, exercise, alanine amino transferase and parameters of lipid profiles, Log adiponectin levels were found to be significantly associated with both CES-D and HAM-A, and Log leptin levels were only significantly associated with HAM-A. CONCLUSIONS The data show that adiponectin and leptin levels are significantly associated with depression and anxiety symptoms. These results suggest that higher adiponectin and lower leptin levels may serve as potential markers related to anxiety and mood in postmenopausal women. More future research that is designed to deal with the important confounders (e.g., population heterogeneity) is needed to investigate comprehensively on these associations.
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Affiliation(s)
- Yu-Ting Wu
- Center for Mitochondrial Medicine and Free Radical Research, Changhua Christian Hospital, Changhua, Taiwan
| | - Wan-Yu Huang
- Pediatrics of Kung-Ten General Hospital, Taichung City, Taiwan
| | - Chew-Teng Kor
- Internal Medicine Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Ko-Hung Liu
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Ting-Yu Chen
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Te Lin
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Hung-Ming Wu
- Inflammation Research & Drug Development Center, Changhua Christian Hospital, Changhua, Taiwan
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
- * E-mail:
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Fouad S, El Shebini SM, Abdel-Moaty M, Ahmed NH, Hussein AMS, Essa HA, Tapozada ST. Menopause Anxiety and Depression; How Food Can Help? Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Anxiety and depression are reported as two major frequent and chief complaints among peri-menopausal women in several societies.
AIM: The objective of the study was to study the effect of using two dietary supplements to beat depression and anxiety associated with menopause.
SUBJECTS AND METHODS: Sixty-six volunteers’ menopausal women participated on the study for 8 weeks, 35 subjects consumed daily cookies prepared mainly from soya flour and flaxseed, and 31 females consumed daily a blend composed mainly of raw unroasted peanut and raw sesame. Follow-up was performed with menopause rating scale, anxiety score, depression score, and biochemical parameters.
RESULTS: Soya cookies were rich in plant-based protein and total phenols while blend was a good source of unsaturated fatty acid. Blend consumers showed significant percentage reduction in beck anxiety score and beck depression score after intervention, more than cookies consumers group. The anthropometrics parameters were statistical significant changed on both groups, more on the group who consumed the soya cookies. Soya cookies demonstrated an anti-inflammatory effect, while blend had an antioxidant and anti-inflammatory effects as was shown on the serum assay of interleukin-6 and malondialdehyde as an inflammatory marker and an antioxidant marker, respectively.
CONCLUSION: From the results, it can be concluded that the supplementation of products enriched with unsaturated fatty acid was more beneficial to slow down the psychological menopause symptoms than natural estrogen rich product consumption.
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Depressive Symptoms among Middle-Aged Women-Understanding the Cause. Brain Sci 2020; 11:brainsci11010026. [PMID: 33379297 PMCID: PMC7824332 DOI: 10.3390/brainsci11010026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022] Open
Abstract
Menopause is an important event in a woman’s life associated with hormonal changes that play a substantial role in the functioning of her body. A decline in the level of estrogens contributes to depressive symptoms and mood disorders during this period. The severity of depressive symptoms experienced by middle-aged women depends on many factors, including sociodemographic data (e.g., menopause, employment status, and marital status) and genetic variables (MAO-A and 5-HTT gene polymorphisms). In order to assess their influence on the development of depression in females, we analyzed 1453 healthy Polish women in different stages of menopause. Based on the results, we found that the l/l + l/s inheritance model for the 5-HTT gene polymorphism was more common in women without and with moderate depressive symptoms according to the Beck Depression Inventory (BDI), while the l/s model was more often observed in women with mild depression. Moreover, the overdominant 3/3 + 4/4 genotype of the MAO-A gene polymorphism was more often found in respondents without depressive symptoms, while women with depressive symptoms had more often the overdominant 3/4 genotype.
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Zeng LN, Yang Y, Feng Y, Cui X, Wang R, Hall BJ, Ungvari GS, Chen L, Xiang YT. The prevalence of depression in menopausal women in China: A meta-analysis of observational studies. J Affect Disord 2019; 256:337-343. [PMID: 31202988 DOI: 10.1016/j.jad.2019.06.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/24/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Depressive symptoms (depression thereafter) are common among menopausal women but findings across studies have been inconsistent. This meta-analysis examined the pooled prevalence of depression among Chinese menopausal women. METHODS Two investigators independently searched both international (PubMed, EMBASE and PsycINFO) and Chinese (CNKI, WanFang, SinoMed and VIP) databases from their inception date until 9 April 2019. Studies that reported the prevalence of depression as measured by the Hamilton Depression Scale (HAMD) were pooled using a random-effects model. RESULTS Twenty-three cross-sectional studies were included in the meta-analysis. The pooled prevalence of depression in menopausal Chinese women was 36.3% (95% CI: 27.5-45.1%), with mild depression of 18.6% (95% CI: 13.4-23.8%), moderate depression of 15.3% (95% CI: 9.4-21.3%), and severe depression of 3.7% (95% CI: 1.9-5.5%). Meta-regression analyses revealed that older age (B = 0.12, z = 8.18, p < 0.001) and better study quality (B = 0. 24, z = 8.33, p < 0.001) was significantly associated with higher depression prevalence. CONCLUSIONS Depression is common among menopausal Chinese women. Due to its negative impact on health, regular screening and effective treatments should be developed for this population.
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Affiliation(s)
- Liang-Nan Zeng
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Macao SAR, China; Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Yuan Yang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Macao SAR, China; Department of Psychiatry and Psychology, Southern Medical University Nanfang Hospital, Guangdong, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Xiling Cui
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong SRA, China
| | - Rixin Wang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Macao SAR, China
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao SAR, China; Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia; The University of Notre Dame Australia, Fremantle, Australia
| | - Ligang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Macao SAR, China.
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Abshirini M, Siassi F, Koohdani F, Qorbani M, Mozaffari H, Aslani Z, Soleymani M, Entezarian M, Sotoudeh G. Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study. Ann Gen Psychiatry 2019; 18:3. [PMID: 30923556 PMCID: PMC6423824 DOI: 10.1186/s12991-019-0225-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 02/20/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Postmenopausal women are at higher risk of mental disorders. Oxidative stress has implication in the development of these disorders. Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing dietary antioxidants intake. The relationship between DTAC with depression, anxiety and stress has not been investigated in postmenopausal women. Thus, we aimed to assess the association between DTAC and depression, stress and anxiety as well as oxidative stress biomarkers. METHODS This cross-sectional study was carried out on 175 postmenopausal women. Data on dietary intake and mental health were collected by 147-item semi-quantitative food frequency questionnaires (FFQ) and Depression Anxiety Stress Scales (DASS-42), respectively. Dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) were measured. ANOVA test was applied to compare the mean of variables across the tertiles of DTAC. The relationship between DTAC and oxidative stress biomarkers was determined through ANCOVA method. Simple and multivariate linear regression tests were performed to measure the relationship between DTAC and mental health. RESULTS Serum MDA level was significantly lower in the subjects at the highest tertiles of DTAC (P-value < 0.001). In addition, serum TAC level was significantly higher in subjects at the second tertile of DTAC (P-value = 0.04). DTAC was inversely and independently related to depression (β = - 0.16, P-value = 0.03) and anxiety scores (β = - 0.21, P-value = 0.007). There was no significant association between DTAC and stress score (β = - 0.10, P-value = 0.1). CONCLUSION An inverse relationship was found between DTAC with depression, anxiety scores and some oxidative stress biomarkers in postmenopausal women. These findings indicate DTAC may be used for developing effective dietary measures for reducing depression and anxiety in these women.
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Affiliation(s)
- Maryam Abshirini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereydoun Siassi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
| | - Fariba Koohdani
- Department of Cellular, Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadis Mozaffari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Aslani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Soleymani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
| | - Mahdieh Entezarian
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
| | - Gity Sotoudeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Hojatdost Street, Naderi Street, Keshavarz Blv., Tehran, Iran
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Li F, He F, Sun Q, Li Q, Zhai Y, Wang X, Zhang T, Lin J. Reproductive history and risk of depressive symptoms in postmenopausal women: A cross-sectional study in eastern China. J Affect Disord 2019; 246:174-181. [PMID: 30583142 DOI: 10.1016/j.jad.2018.12.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 11/03/2018] [Accepted: 12/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although there are potential mechanisms of female hormones in depression, conflicting results still exist in epidemiological studies. This study aimed to determine whether reproductive history, an important indicator of estrogen exposure across the lifetime, is associated with risk of depressive symptoms in postmenopausal women. METHODS We analyzed the baseline data from Zhejiang Ageing and Health Cohort Study including 5537 postmenopausal women. Depressive symptoms were assessed through the application of Patient Health Questionnaire-9 scale (PHQ-9). Logistic regression models, controlling for an extensive range of potential confounders, were generated to examine the association between reproductive history and risk of depressive symptoms in later life. RESULTS Longer reproductive period (Odds Ratio (OR) = 0.972, 95% Confidence Interval (CI) 0.955-0.989), regular menstrual cycle (OR = 0.723, 95% CI 0.525-0.995), later age at first gave birth (OR = 0.953, 95% CI 0.919-0.988) were significantly associated with a reduced risk of late-life depressive symptoms. Among women with regular menstrual cycle, longer cycle length increased the risk (OR = 1.050, 95% CI 1.016-1.085). Meanwhile, more full-term pregnancies and more incomplete pregnancies were related to higher prevalence of depressive symptoms. Women who underwent tubal sterilization as only type of contraceptive surgery were found less likely to suffer depressive symptoms in later life (OR = 0.433, 95% CI 0.348-0.538). LIMITATIONS Cross-sectional data could not make a causation conclusion. CONCLUSIONS Our results indicated that reproductive factors were significantly associated with risk of depressive symptoms in postmenopausal women. Further longitudinal studies are needed.
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Affiliation(s)
- Fudong Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fan He
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qiang Sun
- Tongxiang Center for Disease Control and Prevention, Jiaxing, Zhejiang, China
| | - Qiuyue Li
- Tongxiang Center for Disease Control and Prevention, Jiaxing, Zhejiang, China
| | - Yujia Zhai
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xinyi Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Tao Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Junfen Lin
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
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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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Ahlawat P, Singh MM, Garg S, Mala YM. Prevalence of Depression and its Association with Sociodemographic Factors in Postmenopausal Women in an Urban Resettlement Colony of Delhi. J Midlife Health 2019; 10:33-36. [PMID: 31001054 PMCID: PMC6459070 DOI: 10.4103/jmh.jmh_66_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Menopause is defined as the time of cessation of ovarian function resulting in permanent amenorrhea. Menopause is associated with various symptoms such as physical, vasomotor, sexual, and psychological symptoms. Depression is a common symptom in postmenopausal women as menopause is associated with the end of the fertile period of a women's life. Menopause is an important subject to study as due to increase in life expectancy and improved health care delivery number of postmenopausal women is significantly increasing. Objectives: The objective of the study is to determine the prevalence of depression and its association with sociodemographic factors in postmenopausal women in an urban resettlement colony of Delhi. Materials and Methods: A community-based cross-sectional study was conducted among 580 postmenopausal women who were resident of Gokulpuri in North-East Delhi, using a predesigned, pretested, and semi-structured interview schedule. Hamilton Depression (HAM-D) scale was used to find out the prevalence of depression. The collected data were analyzed using SPSS-22 version. Results: In our study, 58.4% postmenopausal women were normal with no depression, 38.3% were in a mild depression, and 3.3% women were having moderate depression. Depression was more prevalent in women belonging to the younger age group, lower socioeconomic status, and illiterate women. Furthermore, the prevalence of depression was more in women who were divorced or widow. Conclusions: Study revealed prevalence of depression in significant number of postmenopausal women. To improve the quality of life of women in postmenopausal period, diagnosis of depression and relevant influencing factors is important.
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Affiliation(s)
- Pooja Ahlawat
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | | | - Suneela Garg
- Department of Community Medicine, Maulana Azad Medical College, Delhi, India
| | - Y M Mala
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, Delhi, India
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Grochans E, Szkup M, Kotwas A, Kopeć J, Karakiewicz B, Jurczak A. Analysis of Sociodemographic, Psychological, and Genetic Factors Contributing to Depressive symptoms in Pre-, Peri- and Postmenopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040712. [PMID: 29642625 PMCID: PMC5923754 DOI: 10.3390/ijerph15040712] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 12/13/2022]
Abstract
Depressive symptoms that are faced by women in the pre-, peri-, and postmenopausal periods are determined by a wide array of sociodemographic, psychological, and biological variables. The aim of our study was to identify factors that contribute to depressive problems at this stage of life. The study included 815 healthy Polish women aged 45–60 years. The survey part was conducted using the Beck Depression Inventory (BDI), the State–Trait Anxiety Inventory (STAI), the Neuroticism–Extroversion–Openness Five Factor Inventory (NEO-FFI), and a self-developed questionnaire. Genetic analysis was also performed. Depressive symptoms were observed in 25.5% of participants. 70% of the women were postmenopausal. No statistically significant differences in the severity of depressive symptoms were demonstrated with regard to genetic variables (p > 0.05). Reproductive capacity (p < 0.001), employment (p < 0.001), and being married (p < 0.018) were found to reduce the incidence of depressive symptoms. The contribution of personality and anxiety as a trait to depressive symptoms varied. Conclusions: The factors predisposing pre-, peri-, and postmenopausal women to depressive symptoms include lower education, lack of a life partner, unemployment, high anxiety, and neurotic personality. No evidence was found for the contribution of genetic factors to depressive symptoms in the examined women.
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Affiliation(s)
- Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Artur Kotwas
- Department of Public Health, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Jacek Kopeć
- Faculty of Medicine, School of Population and Public Health, The University of British Columbia, 2206 East Mall Vancouver, BC V6T 1Z3, Canada.
| | - Beata Karakiewicz
- Department of Public Health, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
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Onya ON, Otorkpa C. Prevalence and Socio-Demographic Determinants of Depression in Women: A Comparison between Pre-Menopausal and Post-Menopausal Attendees of the General Outpatient Department in Fmc Lokoja. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojd.2018.73004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Azizi M, Fooladi E, Masoumi M, Orimi TG, Elyasi F, Davis SR. Depressive symptoms and their risk factors in midlife women in the Middle East: a systematic review. Climacteric 2017; 21:13-21. [PMID: 29189084 DOI: 10.1080/13697137.2017.1406908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Women may experience different menopausal symptoms across different cultures around the world. The purpose of this study was to determine the prevalence and contributing factors of depression in midlife women in the Middle East. METHODS Electronic databases including PubMed, Medline, PsycINFO, CINAHL, Web of Science, SCOPUS, and Google scholar were searched. The quality of articles was assessed by using the risk of bias tool. RESULTS Sixteen articles were used for this review. The prevalence for depressive symptoms in perimenopausal women is higher than in premenopausal women. The overall data also suggest that depressive symptoms may be more prevalent in postmenopausal women than in premenopausal women. Studies reported sociodemographic, physical, psychological, cultural and sexual risk factors for depressive symptoms in middle-aged women. Risk of bias for a majority of the studies conducted in the Middle Eastern region on depression in midlife was moderate. CONCLUSION Consistent with other areas in the world, midlife women in the Middle East region are at higher risk for depression due to the presence of different factors. High-quality longitudinal studies of representative samples, using validated questionnaires, are needed to provide more accurate prevalence data and the association between menopause and menopausal symptoms in women in the Middle East.
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Affiliation(s)
- M Azizi
- a Counseling in Midwifery master student, Student Research Committee, School of Nursing and Midwifery , Mazandaran University of Medical Sciences Sari , Sari , Iran
| | - E Fooladi
- b Reproductive and Sexual Health Research Centre, School of Nursing and Midwifery , Mazandaran University of Medical Sciences , Sari , Iran
| | - M Masoumi
- a Counseling in Midwifery master student, Student Research Committee, School of Nursing and Midwifery , Mazandaran University of Medical Sciences Sari , Sari , Iran
| | - T Geran Orimi
- c Department of Obstetrics and Gynecology, School of Medicine , Mazandaran University of Medical Sciences , Sari , Iran
| | - F Elyasi
- d Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, School of Medicine , Mazandaran University of Medical Sciences , Sari , Iran
| | - S R Davis
- e Women's Health Research Program, School of Public Health and Preventive Medicine , Monash University , Melbourne , Australia
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Li RX, Ma M, Xiao XR, Xu Y, Chen XY, Li B. Perimenopausal syndrome and mood disorders in perimenopause: prevalence, severity, relationships, and risk factors. Medicine (Baltimore) 2016; 95:e4466. [PMID: 27512863 PMCID: PMC4985318 DOI: 10.1097/md.0000000000004466] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Limited information was focused on perimenopausal syndrome and mood disorders (depression and anxiety) in a specific population: perimenopausal women. We aimed to investigate the prevalence and severity of perimenopausal syndrome and mood disorders, and to analyze their relationships and risk factors in perimenopausal women in Shanghai, China.A cross-sectional study was performed on 1062 women aged 40 to 60 years from 3 communities. The general conditions questionnaire, Kupperman index, self-rating depression scale, and self-rating anxiety scale were used. A multivariable logistic regression analysis was performed to identify risk factors for perimenopausal syndrome and mood disorders.The prevalence of perimenopausal syndrome, depression and anxiety, which were primarily associated with mild symptoms, was 10.92%, 25.99%, and 12.62%, respectively. The differences in the prevalence and severity of perimenopausal syndrome, in the prevalence of depression, and in the severity of anxiety in different age groups were statistically significant (P < 0.001, P = 0.028, P = 0.003, P = 0.002, respectively). The relationships between perimenopausal syndrome and mood disorders were strong and positive (P < 0.001). It was found that age, employment status, personality characteristics, menstruation, and constipation were risk factors for perimenopausal syndrome, but monthly household income was a protective factor. Also, higher income and better medical insurance were beneficial to depression. However, disharmonious family relationships, irregular menstruation, constipation, and severity of perimenopausal syndrome were harmful to depression. For anxiety, attitudes to children status, cesarean section times, and constipation were risk factors.We concluded that perimenopausal syndrome and mood disorders are common in perimenopausal women in Shanghai, whose associations are strong and positive. Many risk factors are associated with and shared between perimenopausal syndrome and mood disorders. Therefore, appropriate management of perimenopause is needed to alleviate the conditions.
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Affiliation(s)
- Rui-xia Li
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University
| | - Min Ma
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
| | - Xi-rong Xiao
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University
| | - Yan Xu
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University
| | - Xiu-ying Chen
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University
| | - Bin Li
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China
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Serra MC, Goldberg AP, Ryan AS. Increased depression and metabolic risk in postmenopausal breast cancer survivors. Diabetol Metab Syndr 2016; 8:44. [PMID: 27453736 PMCID: PMC4957862 DOI: 10.1186/s13098-016-0170-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/14/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Breast cancer survivors (BCS) are at high risk for the development of obesity, type 2 diabetes mellitus, and metabolic syndrome. There is increasing interest in the association between depression and metabolic dysfunction, which is relevant in this population as depression is often present in the chronic phase of cancer recovery. Thus, the aim of this study was to evaluate metabolic risk in BCS with and without depression compared to non-cancer controls. METHODS African American (46 %) and Caucasian (54 %) postmenopausal BCS (N = 28; age: 60 ± 2 years; mean ± SEM) were matched for race, age (±2 years), and BMI (±2 kg/m(2)) to non-cancer controls (N = 28). Center for Epidemiologic Studies Depression Scale (CES-D) >16 or antidepressant medication usage was used to classify depression. Metabolic status was defined by 2-hr glucose during an OGTT and classification of metabolic syndrome. RESULTS Compared to non-cancer controls, BCS had similar 2-hr glucose, but higher fasting glucose and total cholesterol, and were 2.5 times more likely to have metabolic syndrome (21 vs. 52 %)(P's < 0.05). Conversely, HDL-C was 16 % higher in BCS (P < 0.05). Forty three % of BCS were on antidepressants compared to 14 % in non-cancer controls, despite similar mean CES-D scores (6 ± 1). Depressed BCS (46 %) had a higher BMI, waist circumference, fasting glucose, and more metabolic syndrome components than non-depressed BCS (P's < 0.05). CONCLUSIONS BCS have a heightened prevalence of depression that may be associated with an increased prevalence of metabolic syndrome. These results support the need to monitor weight gain, depression, and the progression of metabolic abnormalities after cancer diagnosis and treatment. Further studies into the mechanistic link between depression and metabolic disease are necessary to identify strategies that can offset their impact on obesity and associated cardiovascular risk following a breast cancer diagnosis.
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Affiliation(s)
- Monica C. Serra
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine and Geriatric Research and Education Clinical Center, Baltimore VA Medical Center, 10 N Greene St. (BT/18/GR), Baltimore, MD 21201 USA
| | - Andrew P. Goldberg
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine and Geriatric Research and Education Clinical Center, Baltimore VA Medical Center, 10 N Greene St. (BT/18/GR), Baltimore, MD 21201 USA
| | - Alice S. Ryan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine and Geriatric Research and Education Clinical Center, Baltimore VA Medical Center, 10 N Greene St. (BT/18/GR), Baltimore, MD 21201 USA
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Lee JY, Park YK, Cho KH, Kim SM, Choi YS, Kim DH, Nam GE, Han KD, Kim YH. Suicidal ideation among postmenopausal women on hormone replacement therapy: The Korean National Health and Nutrition Examination Survey (KNHANES V) from 2010 to 2012. J Affect Disord 2016; 189:214-9. [PMID: 26451506 DOI: 10.1016/j.jad.2015.09.068] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Suicide is a major public health problem around the world. Some studies have found that hormone replacement therapy (HRT) is associated with depression in postmenopausal women. Depression is a well-known risk factor for suicide; therefore, we investigated the relationship between HRT and suicidal ideation in postmenopausal Korean women. METHODS We included 2286 postmenopausal women with or without HRT from the Korean National Health and Nutrition Examination Survey 2010-2012. The use and duration of HRT and mental health status, including stress, depressive mood, and suicidal ideation and attempts, were assessed by self-report questionnaires. RESULTS The proportion of participants with depressive mood and suicidal ideation was higher in the HRT group than the non-HRT group (all p values<0.05). As the duration of HRT increased, the percentage of participants with suicidal ideation increased (p for trend=0.006). After adjusting for all covariates, the odds ratio (95% confidence intervals) for suicidal ideation was 1.742 (1.223-2.482) in the women with HRT, compared to women without HRT. HRT duration longer than 10 years was associated with suicidal ideation (odds ratio=2.089 and 95% confidence intervals=1.069-4.084). LIMITATIONS The cross-sectional design, a possibility of incorrect answer about menopausal status, and no assessment of the type of HRT are the main limitations of this study. CONCLUSION Postmenopausal women receiving HRT, especially for more than 10 years, showed increased suicidal ideation compared with postmenopausal women without HRT. Physicians should pay attention to mood symptoms and suicidal ideation in postmenopausal women with HRT.
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Affiliation(s)
- Ji-Yoon Lee
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yong-Kyu Park
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Seon-Mee Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Youn-Seon Choi
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ga-Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea.
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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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Barth C, Villringer A, Sacher J. Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Front Neurosci 2015; 9:37. [PMID: 25750611 PMCID: PMC4335177 DOI: 10.3389/fnins.2015.00037] [Citation(s) in RCA: 364] [Impact Index Per Article: 40.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/26/2015] [Indexed: 12/21/2022] Open
Abstract
Sex hormones have been implicated in neurite outgrowth, synaptogenesis, dendritic branching, myelination and other important mechanisms of neural plasticity. Here we review the evidence from animal experiments and human studies reporting interactions between sex hormones and the dominant neurotransmitters, such as serotonin, dopamine, GABA and glutamate. We provide an overview of accumulating data during physiological and pathological conditions and discuss currently conceptualized theories on how sex hormones potentially trigger neuroplasticity changes through these four neurochemical systems. Many brain regions have been demonstrated to express high densities for estrogen- and progesterone receptors, such as the amygdala, the hypothalamus, and the hippocampus. As the hippocampus is of particular relevance in the context of mediating structural plasticity in the adult brain, we put particular emphasis on what evidence could be gathered thus far that links differences in behavior, neurochemical patterns and hippocampal structure to a changing hormonal environment. Finally, we discuss how physiologically occurring hormonal transition periods in humans can be used to model how changes in sex hormones influence functional connectivity, neurotransmission and brain structure in vivo.
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Affiliation(s)
- Claudia Barth
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany ; Clinic of Cognitive Neurology, University of Leipzig Leipzig, Germany ; Leipzig Research Center for Civilization Diseases, University of Leipzig Leipzig, Germany ; Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig Leipzig, Germany ; Berlin School of Mind and Brain, Mind and Brain Institute Berlin, Germany
| | - Julia Sacher
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany ; Clinic of Cognitive Neurology, University of Leipzig Leipzig, Germany
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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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Lifetime endogenous reproductive factors and severe depressive symptoms in postmenopausal women. Menopause 2013; 20:1154-63. [DOI: 10.1097/gme.0000000000000098] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang HL, Booth-LaForce C, Tang SM, Wu WR, Chen CH. Depressive symptoms in Taiwanese women during the peri- and post-menopause years: associations with demographic, health, and psychosocial characteristics. Maturitas 2013; 75:355-60. [PMID: 23726260 DOI: 10.1016/j.maturitas.2013.04.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 03/27/2013] [Accepted: 04/28/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the prevalence of depressive symptoms in peri- and post-menopausal Taiwanese women, and to investigate the relation between depressive symptoms and demographic variables, chronic disease status, health habits, stress management, menopausal symptoms, and attitudes toward menopause and aging. STUDY DESIGN Cross-sectional study, using a purposive sample of 566 women between 45 and 60 years of age from a medical center and residential community in Southern Taiwan. MAIN OUTCOME MEASURES Demographic and health habits questionnaire, Women's Health Initiative Symptom Scale, Attitudes Toward Menopause and Aging Scale, and Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS The prevalence of depressive symptoms (CES-D score≥16) was 38.7% in peri- and post-menopausal Taiwanese women. Bivariate correlations and analyses of variance indicated that higher CES-D scores were related to lower family income, younger age, smoking for a greater number of years, consuming more alcohol, having multiple chronic diseases, not exercising regularly, consulting with a specialist for stress management, having more severe menopausal symptoms, and more negative attitudes toward menopause and aging. A stepwise multiple regression analysis indicated that the key predictors, accounting for 33.7% of the variance, were menopausal symptoms, attitudes toward menopause and aging, family income, and chronic disease status. CONCLUSIONS Results highlight the importance of considering psychosocial factors, life style, and chronic disease management in providing health guidance for peri- and post-menopausal women to enhance their quality of life and reduce the risk of depressive symptoms.
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Affiliation(s)
- Hui-Ling Wang
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Depressive disorders and the menopause transition. Maturitas 2012; 71:120-30. [DOI: 10.1016/j.maturitas.2011.11.017] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 11/18/2011] [Indexed: 11/22/2022]
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