期刊
PSYCHOLOGICAL MEDICINE
卷 39, 期 1, 页码 55-64出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291708003218
关键词
Incident major depression; longitudinal study; menopause; midlife women
资金
- National Institutes of Health [R01 MH59689]
- DHHS
- National Institute on Aging
- National Institute of Nursing Research
- NIH Office of Research on Women's Health [NR004061, AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012534, AG012495]
Background. Little is known about factors that predict first lifetime episodes of major depression in middle-aged women. It is not known whether health-related factors and life stress pose more or less of a risk to the onset of clinical depression than does the menopausal transition. Method. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to assess diagnoses of life-time, annual and current major depression in a community-based sample of premenopausal or early perimenopausal African American and White women. Menstrual cycle characteristics, psychosocial and health-related factors, and blood samples for assay of reproductive hormones were obtained annually. Two hundred and sixty-six women without a history of major depression at baseline constituted the cohort for the current analyses. Results. Over 7 years of follow-up, 42 (15.8%) women met criteria for a diagnosis of major depression. Frequent vasomotor symptoms (VMS; hot flashes and/or night sweats) (HR 2.14, p = 0.03) were a significant predictor of major depression in univariate analyses. After simultaneous adjustment for multiple predictors in Cox proportional hazards analyses, frequent VMS were no longer significant; lifetime history of an anxiety disorder (HR 2.20, p = 0.02) and role limitations due to physical health (HR 1.88, p = 0.07) at baseline and a very stressful life event (HR 2.25, p = 0.04) prior to depression onset predicted a first episode of major depression. Conclusions. Both earlier (e.g. history of anxiety disorders) and more proximal factors (e.g. life stress) may be more important than VMS in contributing to a first episode of major depression during midlife.
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