TY - JOUR
T1 - Depression and its influence on reproductive endocrine and menstrual cycle markers associated with perimenopause
T2 - The Harvard Study of Moods and Cycles
AU - Harlow, Bernard L.
AU - Wise, Lauren A.
AU - Otto, Michael W.
AU - Soares, Claudio N.
AU - Cohen, Lee S.
PY - 2003/1/1
Y1 - 2003/1/1
N2 - Background: Few studies have determined the impact of a lifetime history of major depression on an early transition to menopause. Methods: Reproductive and psychiatric interviews and early follicular-phase blood specimens were obtained at study enrollment and every 6 months during 36 months of follow-up from 332 women with and 644 women without a history of major depression, 36 to 45 years of age. We used menstrual cycle markers to determine inception of perimenopause, defined as time from study enrollment to a follow-up interview with: (1) 7-day or more change in menstrual cycle length; (2) a change in menstrual flow amount or duration; or (3) amenorrhea lasting at least 3 months. Results: Women with a history of depression had 1.2 times the rate of perimenopause of women with no such history (95% confidence interval, 0.9-1.6). Compared with nondepressed women, depressed women with more pronounced depressive symptoms at study enrollment (Hamilton Rating Scale for Depression scores >8) had twice the risk of an earlier perimenopausal transition. Among the women with greater depressive symptoms (Hamilton scores >8), those who also reported use of antidepressants had nearly 3 times the risk of an earlier perimenopausal transition (hazard ratio, 2.7; 95% confidence interval, 1.5-4.8) of nondepressed women. Women with a lifetime history of depression also had higher follicle-stimulating hormone and luteinizing hormone levels and lower estradiol levels at study enrollment and during the follow-up period after adjustment for covariates. Conclusion: A lifetime history of major depression may be associated with an early decline in ovarian function.
AB - Background: Few studies have determined the impact of a lifetime history of major depression on an early transition to menopause. Methods: Reproductive and psychiatric interviews and early follicular-phase blood specimens were obtained at study enrollment and every 6 months during 36 months of follow-up from 332 women with and 644 women without a history of major depression, 36 to 45 years of age. We used menstrual cycle markers to determine inception of perimenopause, defined as time from study enrollment to a follow-up interview with: (1) 7-day or more change in menstrual cycle length; (2) a change in menstrual flow amount or duration; or (3) amenorrhea lasting at least 3 months. Results: Women with a history of depression had 1.2 times the rate of perimenopause of women with no such history (95% confidence interval, 0.9-1.6). Compared with nondepressed women, depressed women with more pronounced depressive symptoms at study enrollment (Hamilton Rating Scale for Depression scores >8) had twice the risk of an earlier perimenopausal transition. Among the women with greater depressive symptoms (Hamilton scores >8), those who also reported use of antidepressants had nearly 3 times the risk of an earlier perimenopausal transition (hazard ratio, 2.7; 95% confidence interval, 1.5-4.8) of nondepressed women. Women with a lifetime history of depression also had higher follicle-stimulating hormone and luteinizing hormone levels and lower estradiol levels at study enrollment and during the follow-up period after adjustment for covariates. Conclusion: A lifetime history of major depression may be associated with an early decline in ovarian function.
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U2 - 10.1001/archpsyc.60.1.29
DO - 10.1001/archpsyc.60.1.29
M3 - Article
C2 - 12511170
AN - SCOPUS:0037225061
SN - 0003-990X
VL - 60
SP - 29
EP - 36
JO - Archives of General Psychiatry
JF - Archives of General Psychiatry
IS - 1
ER -