title: Prevalence and predictors of depressive symptoms in older premenopausal women: the Harvard Study of Moods and Cycles.
abstract: BACKGROUND
  The Harvard Study of Moods and Cycles is a community-based cohort study designed to evaluate the relationship between major depression and changes in menstrual and ovarian function.
  
  
  METHODS
  All women aged 36 to 44 years with a verifiable address from 7 Boston, Mass, metropolitan communities were selected from the Massachusetts Town Books. A self-administered questionnaire assessed demographic characteristics and menstrual history, depression history, and current depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D]) in 4161 women.
  
  
  RESULTS
  We observed a score of 16 or more on the CES-D in 22.4% of women surveyed, and 8.6% scored 25 or more. Widowed, divorced, or separated women were twice as likely as married women to have depression scores greater than 16 (95% confidence interval, 1.6-2.8), and smokers in the upper tertile of pack-years were 1.9 times more likely to have CES-D scores of 16 or more (95% confidence interval, 1.5-2.3). Relative to nulliparous women, those with 1 or 2 children had a 30% lower risk of historic mood disorder, and those with 3 or more children had an even greater reduction in risk (odds ratio, 0.4; 95% confidence interval, 0.3-0.6). Menstrual cycle irregularities were largely unassociated with current or past depression. However, 5 of 8 premenstrual symptoms were significantly associated with CES-D scores of 16 or more.
  
  
  CONCLUSIONS
  These findings corroborate the prevalence of depression reported by other community-based studies, and also support a relationship between depressive symptoms and marital status, cigarette smoking, nulliparity, and premenstrual symptoms.
authors.affiliation: Harvard Medical School, Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Mass 02115, USA. bharlow@rics.bwh.harvard.edu
authors.forename: B L
authors.initials: BL
authors.lastname: Harlow
authors.forename: L S
authors.initials: LS
authors.lastname: Cohen
authors.forename: M W
authors.initials: MW
authors.lastname: Otto
authors.forename: D
authors.initials: D
authors.lastname: Spiegelman
authors.forename: D W
authors.initials: DW
authors.lastname: Cramer
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D017533:Marital Status; D008404:Massachusetts / Q000453:epidemiology; D008597:Menstrual Cycle; D010298:Parity; D017697:Premenopause; D011293:Premenstrual Syndrome / Q000453:epidemiology; D015995:Prevalence; D011336:Probability; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology