Psychological Medicine
Major depression during and after the menopausal transition:...
Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN)
Published online by Cambridge University Press: 09 February 2011
J. T. Bromberger ,
H. M. Kravitz ,
Y.-F. Chang ,
J. M. Cyranowski ,
C. Brown and
K. A. Matthews
J. T. Bromberger
Departments of Epidemiology and Psychiatry, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
H. M. Kravitz
Departments of Psychiatry and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
Y.-F. Chang
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
J. M. Cyranowski
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
C. Brown
Departments of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh, Pittsburgh, PA, USA
Corresponding
brombergerjt@upmc.edu
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It is unclear whether risk for major depression during the menopausal transition or immediately thereafter is increased relative to pre-menopause. We aimed to examine whether the odds of experiencing major depression were greater when women were peri- or post-menopausal compared to when they were pre-menopausal, independent of a history of major depression at study entry and annual measures of vasomotor symptoms (VMS), serum levels of, or changes in, estradiol (E2), follicular stimulating hormone (FSH) or testosterone (T) and relevant confounders.
Participants included the 221 African American and Caucasian women, aged 42–52 years, who were pre-menopausal at entry into the Pittsburgh site of a community-based study of menopause, the Study of Women's Health Across the Nation (SWAN). We conducted the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) to assess diagnoses of lifetime, annual and current major depression at baseline and at annual follow-ups. Psychosocial and health factors, and blood samples for assay of reproductive hormones, were obtained annually.
Women were two to four times more likely to experience a major depressive episode (MDE) when they were peri-menopausal or early post-menopausal. Repeated-measures logistic regression analyses showed that the effect of menopausal status was independent of history of major depression and annually measured upsetting life events, psychotropic medication use, VMS and serum levels of or changes in reproductive hormones. History of major depression was a strong predictor of major depression throughout the study.
The risk of major depression is greater for women during and immediately after the menopausal transition than when they are pre-menopausal.
Longitudinal major depression menopause
Psychological Medicine , Volume 41 , Issue 9 , September 2011 , pp. 1879 - 1888
DOI: https://doi.org/10.1017/S003329171100016X[Opens in a new window]
Copyright © Cambridge University Press 2011
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Avis, NE, Brambilla, D, McKinlay, SM, Vass, K (1994). A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts Women's Health Study. Annals of Epidemiology 4, 214–220.CrossRefGoogle ScholarPubMed
Bromberger, JT, Matthews, KA, Schott, LL, Brockwell, S, Avis, N, Kravitz, HM, Everson-Rose, SA, Gold, EB, Sowers, M, Randolph, J Jr. (2007). Depressive symptoms during the menopausal transition: the Study of Women's Health Across the Nation (SWAN). Journal of Affective Disorders 103, 267–272.CrossRefGoogle Scholar
Burger, HG, Dudley, EC, Hopper, JL, Groome, N, Guthrie, JR, Green, A, Dennerstein, L (1999). Prospectively measured levels of serum follicle-stimulating hormone, estradiol, and the dimeric inhibins during the menopausal transition in a population-based cohort of women. Journal of Clinical Endocrinology and Metabolism 84, 4025–4030.Google Scholar
Cohen, LS, Soares, CN, Vitonis, AF, Otto, MW, Harlow, BL (2006). Risk for new onset of depression during the menopausal transition. The Harvard Study of Moods and Cycles. Archives of General Psychiatry 63, 385–390.CrossRefGoogle ScholarPubMed
Freeman, EW, Sammel, MD, Lin, H, Nelson, DB (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry 63, 375–382.CrossRefGoogle ScholarPubMed
Freeman, EW, Sammel, MD, Lui, L, Gracia, CR, Nelson, DB, Hollander, L (2004). Hormones and menopausal status as predictors of depression in women in transition to menopause. Archives of General Psychiatry 61, 62–70.CrossRefGoogle ScholarPubMed
Hunter, M (1992). The southeast England longitudinal study of the climacteric and postmenopause. Maturitas 14, 117–126.CrossRefGoogle Scholar
Kaufert, PA, Gilbert, P, Tate, R (1992). The Manitoba Project: a re-examination of the link between menopause and depression. Maturitas 114, 143–155.CrossRefGoogle Scholar
Kendler, KS, Gardner, CO (2010). Dependent stressful life events and prior depressive episodes in the prediction of major depression. Archives of General Psychiatry 67, 1120–1127.CrossRefGoogle ScholarPubMed
Kuh, DL, Wadsworth, M, Hardy, R (1997). Women's health in midlife: the influence of the menopause, social factors and health in earlier life. British Journal of Obstetrics and Gynaecology 104, 923–933.CrossRefGoogle ScholarPubMed
Maarten, LW, Knottnerus, JA, Pop, VJ (2002). Menopausal transition and increased depressive symptomatology: a community based prospective study. Maturitas 42, 195–200.CrossRefGoogle Scholar
Matthews, KA, Bromberger, JT, Egland, G (1990). Behavioral antecedents and consequences of the menopause. In The Menopause(ed. Korenman, S. G.), pp. 1–15. Serono Symposia: Norwell, MA.Google ScholarPubMed
Matthews, KA, Wing, RR, Kuller, LH, Leilahn, EN, Plantinga, P (1994). Influence of the perimenopause on cardiovascular risk factors and symptoms of middle-aged healthy women. Archives of Internal Medicine 20, 2349–2355.CrossRefGoogle Scholar
McKinlay, SM, Jefferys, M (1974). The menopausal syndrome. British Journal of Preventive and Social Medicine 28, 108–115.Google ScholarPubMed
Neugarten, BL, Kraines, RJ (1965). 'Menopausal symptoms' in women of various ages. Psychosomatic Medicine 27, 266–273.CrossRefGoogle Scholar
O'Connor, VM, Del Mar, CB, Sheehan, M, Siskind, V, Fox-Young, S, Cragg, C (1994). Do psychosocial factors contribute more to symptom reporting by middle-aged women than hormonal status? Maturitas 20, 63–69.CrossRefGoogle ScholarPubMed
Randolph, JF, Sowers, MF, Bondarenko, I, Gold, EB, Greendale, GA, Bromberger, JT, Brockwell, SE, Matthews, KA (2005). The relationship change in reproductive hormones and vasomotor symptoms during the menopausal transition. Journal of Clinical Endocrinology and Metabolism 90, 6106–6112.CrossRefGoogle ScholarPubMed
Schmidt, PJ, Murphy, JH, Haq, N, Danaceau, MA, St Clair, LS (2002). Basal plasma hormones levels in depressed perimenopausal women. Psychoneuroendocrinology 27, 907–920.CrossRefGoogle ScholarPubMed
Schmidt, PJ, Nazli, H, Rubinow, DR (2004). A longitudinal evaluation of the relationship between reproductive status and mood in perimenopausal women. American Journal of Psychiatry 161, 2238–2244.CrossRefGoogle ScholarPubMed
Sowers, MF, Crawford, S, Sternfeld, B, Morganstein, D, Gold, EB, Greendale, GA, Evans, D, Neer, R, Matthews, KA, Sherman, S, Lo, A, Weiss, G, Kelsey, J (2000). SWAN: a multi-center, multi-ethnic, community-based cohort study of women and the menopause. In Menopause: Biology and Pathobiology(ed. Lobo, R., Kelsey, J. and Marcus, R.), pp. 175–178. Academic Press: San Diego, CA.CrossRefGoogle Scholar
Spitzer, RL, William, JB, Gibbon, M, First, MB (1992). The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description. Archives of General Psychiatry 49, 624–629.CrossRefGoogle ScholarPubMed
Weissman, M (1979). The myth of involutional melancholia. Journal of the American Medical Association 242, 742–744.CrossRefGoogle ScholarPubMed
WHO (1996). Research on the Menopause in the 1990s. WHO Technical Report Series: 866. World Health Organization: Geneva, Switzerland.Google Scholar
Williams, JB, Gibbon, M, First, MB, Spitzer, RL, Davies, M, Borus, J, Howes, MJ, Kane, J, Pope, Jr. HG, Rounsaville, B (1992). The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability. Archives of General Psychiatry 49, 630–636.CrossRefGoogle ScholarPubMed
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Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN) – Corrigendum
Psychological Medicine, Volume 41, Issue 10
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Genazzani, Andrea R. and Gambacciani, Marco 2011. Vasomotor symptoms and negative affect. Menopause, Vol. 18, Issue. 12, p. 1265.
2011. Major depression during and after the menopausal transition: Study of Women's Health Across the Nation (SWAN) – Corrigendum. Psychological Medicine, Vol. 41, Issue. 10, p. 2238.
Worsley, Roisin Davis, Susan R. Gavrilidis, Emorfia Gibbs, Zoe Lee, Stuart Burger, Henry and Kulkarni, Jayashri 2012. Hormonal therapies for new onset and relapsed depression during perimenopause. Maturitas, Vol. 73, Issue. 2, p. 127.
Rogines-Velo, Maria Pia Heberle, Amy E. and Joffe, Hadine 2012. Effect of medroxyprogesterone on depressive symptoms in depressed and nondepressed perimenopausal and postmenopausal women after discontinuation of transdermal estradiol therapy. Menopause, Vol. 19, Issue. 4, p. 471.
Solís-Ortiz, Silvia Pérez-Luque, Elva and Pacheco-Zavala, Maria del Pilar 2012. Resting EEG Activity and Ovarian Hormones as Predictors of Depressive Symptoms in Postmenopausal Women without a Diagnosis of Major Depression. Psychology, Vol. 03, Issue. 09, p. 834.
Llaneza, Plácido García-Portilla, María P. Llaneza-Suárez, David Armott, Begoña and Pérez-López, Faustino R. 2012. Depressive disorders and the menopause transition. Maturitas, Vol. 71, Issue. 2, p. 120.
Hall, James R. Johnson, Leigh A. Vo, Hoa T. Barber, Robert C. Scott Winter, A. and O'Bryant, Sid E. 2012. Biomarkers and Depressive Symptoms in Older Women with and without Cognitive Impairment. Journal of Behavioral and Brain Science, Vol. 02, Issue. 02, p. 276.
Creech, R.D. Li, Q. Carrasco, G.A. Van de Kar, L.D. and Muma, N.A. 2012. Estradiol induces partial desensitization of serotonin 1A receptor signaling in the paraventricular nucleus of the hypothalamus and alters expression and interaction of RGSZ1 and Gαz. Neuropharmacology, Vol. 62, Issue. 5-6, p. 2040.
Maki, Pauline M. 2012. Mood and the aging ovary. Menopause: The Journal of The North American Menopause Society, Vol. 19, Issue. 11, p. 1167.
Kim, Catherine 2012. Does Menopause Increase Diabetes Risk? Strategies for Diabetes Prevention in Midlife Women. Women's Health, Vol. 8, Issue. 2, p. 155.
Villaverde Gutiérrez, Carmen Torres Luque, Gema Ábalos Medina, Gracia M Argente del Castillo, Maria J Guisado, Isabel M Guisado Barrilao, Rafael and Ramírez Rodrigo, Jesús 2012. Influence of exercise on mood in postmenopausal women. Journal of Clinical Nursing, Vol. 21, Issue. 7-8, p. 923.
Maki, Pauline M. Rubin, Leah H. Cohen, Mardge Golub, Elizabeth T. Greenblatt, Ruth M. Young, Mary Schwartz, Rebecca M. Anastos, Kathryn and Cook, Judith A. 2012. Depressive symptoms are increased in the early perimenopausal stage in ethnically diverse human immunodeficiency virus–infected and human immunodeficiency virus–uninfected women. Menopause: The Journal of The North American Menopause Society, Vol. 19, Issue. 11, p. 1215.
Lin, H-L. Hsiao, M-C. Liu, Y-T. and Chang, C-M. 2013. Perimenopause and incidence of depression in midlife women: a population-based study in Taiwan. Climacteric, Vol. 16, Issue. 3, p. 381.
Kanapathipillai, Rupa Hickey, Martha and Giles, Michelle 2013. Human immunodeficiency virus and menopause. Menopause: The Journal of The North American Menopause Society, Vol. 20, Issue. 9, p. 983.
Al-Safi, Zain A and Santoro, Nanette 2013. SWAN: Key Findings to Date and more to Come. Women's Health, Vol. 9, Issue. 3, p. 217.
Green, Sheryl M. Haber, Erika McCabe, Randi E. and Soares, Claudio N. 2013. Cognitive–behavioral group treatment for menopausal symptoms: a pilot study. Archives of Women's Mental Health, Vol. 16, Issue. 4, p. 325.
Gibbs, Zoe Lee, Stuart and Kulkarni, Jayashri 2013. Factors Associated with Depression During the Perimenopausal Transition. Women's Health Issues, Vol. 23, Issue. 5, p. e301.
Bleil, Maria E. Bromberger, Joyce T. Latham, Melissa D. Adler, Nancy E. Pasch, Lauri A. Gregorich, Steven E. Rosen, Mitchell P. and Cedars, Marcelle I. 2013. Disruptions in ovarian function are related to depression and cardiometabolic risk during premenopause. Menopause, Vol. 20, Issue. 6, p. 631.
Stuenkel, Cynthia A. 2013. Women and Health. p. 899.
Chen, Mu-Hong Su, Tung-Ping Li, Cheng-Ta Chang, Wen-Han Chen, Tzeng-Ji Bai, Ya-Mei and O'Connor, Kathleen A. 2013. Symptomatic Menopausal Transition Increases the Risk of New-Onset Depressive Disorder in Later Life: A Nationwide Prospective Cohort Study in Taiwan. PLoS ONE, Vol. 8, Issue. 3, p. e59899.
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J. T. Bromberger (a1), H. M. Kravitz (a2), Y.-F. Chang (a3), J. M. Cyranowski (a4), C. Brown (a4) and K. A. Matthews (a5)
DOI: https://doi.org/10.1017/S003329171100016X